MSA ALLIANCE, LLC (NPI# 1154661825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154661825 |
| Entity Type | Organization |
| Organization Name | MSA ALLIANCE, LLC |
| Practice Address |
1 Broadway Plz Sparta IL 62286-1800 |
| Mailing Address |
4500 Memorial Dr Medical Affairs Credential Dept Belleville IL 62226-5360 |
| Practice Telephone | 6182221020 |
| Mailing Telephone | 6182574644 |
| Mailing Fax Number | 6182576946 |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2013-02-22 |
| Authorized Official Name | JAMES B. DAVIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6182574644 |
| Is Organization Subpart | Y |
| Parent Organization Name | MSA ALLIANCE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518369438 | Msa Alliance, LLC | Psychiatry & Neurology | 4550 Memorial Dr Ste 340, Suite 340, Belleville, IL 62226-5372 | 2014-09-23 |
| 1760819676 | Msa Alliance, LLC | Family Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2013-10-09 |
| 1366781171 | Msa Alliance, LLC | Internal Medicine | 624 Vons-jost, Waterloo, IL 62298-1592 | 2013-02-14 |
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| 1972020279 | Msa Alliance, LLC | Surgery | 1414 Cross St Ste 210, Shiloh, IL 62269-2988 | 2017-08-28 |
| 1134642531 | Msa Alliance, LLC | Internal Medicine | 1414 Cross St Ste 210, Shiloh, IL 62269-2988 | 2017-07-18 |
| 1093258154 | Msa Alliance, LLC | Surgery | 2 Memorial Dr, Suite 201, Alton, IL 62002-6723 | 2016-11-22 |
| 1801339965 | Msa Alliance, LLC | Surgery | 2016 Vadalabene Dr, Suite B, Maryville, IL 62062-6901 | 2016-11-22 |
| 1760939060 | Msa Alliance, LLC | Internal Medicine | 1404 Cross St, Suite 2114, Shiloh, IL 62269-2988 | 2016-09-02 |
| 1053711895 | Msa Alliance, LLC | Surgery | 2133 Vadalabene Dr, Suite 2, Maryville, IL 62062-5839 | 2014-08-29 |
| Street Address |
1 BROADWAY PLZ |
| City | SPARTA |
| State | IL |
| Zip Code | 62286-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467841502 | Rikki Schaefer | Physician Assistant | 205 South Burns Ave, Sparta, IL 62286 | 2015-01-13 |
| 1922242130 | Sparta Community Hospital | Clinic/Center | 211 South Burns Avenue, Sparta, IL 62286 | 2009-05-01 |
| 1245452739 | Human Service Center of Southern Metro East | Clinic/Center | 104 Northtown Drive, Sparta, IL 62286 | 2007-05-03 |
| 1356479497 | Randal W Mcbride | Dentist | 1701 N Market St, Suite 2, Sparta, IL 62286 | 2007-03-01 |
| 1043398050 | Chris M Murry | Chiropractor | 401 West Broadway, Sparta, IL 62286 | 2006-11-01 |
| 1679657548 | Frantz Antoine Charles | Surgery | 818 East Broadway, Sparta Community Hospital, Sparta, IL 62286 | 2006-10-25 |
| 1750497194 | Sparta Community Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 207 South Burns Ave, Family Health Centre, Sparta, IL 62286 | 2006-08-21 |
| 1740395045 | Sparta Community Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 1300 North Campus, Sparta Community Hospital, North Campus, Sparta, IL 62286 | 2006-08-20 |
| 1326153552 | Sparta Communty Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 211 South Burns Ave, Quality Healthcare Surgery, Sparta, IL 62286 | 2006-08-20 |
| 1740395003 | Sparta Community Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 215 South Burns Avenue, Sparta, IL 62286 | 2006-08-20 |
| Find all providers in zip 62286 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558555227 | Hazari Muduli, Md, LLC | Surgery | 350 Sparta Ave, Unit B6b, Sparta, NJ 07871-1150 | 2007-09-05 |
| 1558333047 | Hazari Muduli | Surgery | 350 Sparta Ave, Unit Ab2a, Sparta, NJ 07871-1150 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1588959548 | Patrick Michael Sullivan Neville | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2011-06-17 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.