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General NPI Number Information
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NPI Number | 1669709317
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Entity Type | Organization
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Legal Business Name | ASSOCIATED PHYSICIANS GROUP LTD
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 1181 S STATE ROUTE 157 SUITE 200C
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3710
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Country | US
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Telephone | 618-588-4100
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Fax | 618-307-3283
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Provider Business Mailing Address
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Address Line | 1181 S STATE ROUTE 157 SUITE 200C
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3710
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Country | US
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Telephone | 618-588-4100
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Fax | 618-307-3283
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Authorized Official
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Title or Position | OWNER
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Name | JOHN S VICK
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Credential | D.C.
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Telephone | 618-632-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 038007328
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License Number State | IL
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