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General NPI Number Information
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NPI Number | 1376163261
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Entity Type | Individual
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Provider Name | MD S ALI MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 4500 MEMORIAL DR
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City | BELLEVILLE
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State | IL
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Zip | 62226-5360
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Country | US
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Telephone | 618-257-6220
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 959203
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9203
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Country | US
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Telephone | 618-257-6220
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Fax | 618-257-6679
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036166566
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036166566
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License Number State | IL
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