MEDICARE: QUEEN CITY GENERAL & VASCULAR SURGEONS GROUP LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician
2	208600000X	Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	CD8400	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548297807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEEN CITY GENERAL & VASCULAR SURGEONS GROUP LTD

Provider Business Mailing Address
First Line	:	1270 SOLUTIONS CENTER
Second Line	:	PO BOX 771270
City	:	CHICAGO
State	:	IL
Zip	:	60677-1002
Country	:	US
Telephone Number	:	513-542-6898
Fax Number	:	513-542-7972

Provider Business Practice Location Address
First Line	:	7502 STATE RD
Second Line	:	STE. 1180
City	:	CINCINNATI
State	:	OH
Zip	:	45255-2800
Country	:	US
Telephone Number	:	513-232-8181
Fax Number	:	513-624-2964

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. PEGGY ERTEL
Credential	:
Telephone Number	:	513-232-8181

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	11/22/2011

Similar Medicare Providers

1235116757 — DR. THOMAS CURRY MAYNARD M.D.
Practice Location Address:

7502 STATE RD , STE. 1180
CINCINNATI, OH
45255-2800

Practice Phone: 513-232-8181
Practice Fax: 513-624-2956

1619954021 — DR. DAVID DALE KIRKPATRICK III M.D.
Practice Location Address:

7502 STATE RD , STE. 1180
CINCINNATI, OH
45255-2800

Practice Phone: 513-232-8181
Practice Fax: 513-624-2956

1760469183 — DR. STUART LEE DONOVAN M.D.
Practice Location Address:

7502 STATE RD , STE. 1180
CINCINNATI, OH
45255-2800

Practice Phone: 513-232-8181
Practice Fax: 513-624-2956

1689603094 — DR. ROBERT GRAYDON BRADLEY MD
Practice Location Address:

7502 STATE ROAD , SUITE 1180
CINCINNATI, OH
45255-2800

Practice Phone: 513-232-8181
Practice Fax: 513-624-2956

1104042506 — RIVER VALLEY DIALYSIS LLC
Practice Location Address:

7502 STATE RD , STE 1160
CINCINNATI, OH
45255-2800

Practice Phone: 513-624-0400
Practice Fax: 513-624-0182

1851597843 — DR. EMILY MITCHELL SIMPSON M.D.
Practice Location Address:

7502 STATE RD STE 3310
CINCINNATI, OH
45255-2800

Practice Phone: 513-735-1529
Practice Fax: 513-686-5620

Directions to “QUEEN CITY GENERAL & VASCULAR SURGEONS GROUP LTD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.