MSA ALLIANCE, LLC (NPI# 1255647228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255647228 |
| Entity Type | Organization |
| Organization Name | MSA ALLIANCE, LLC |
| Practice Address |
9515 Holy Cross Ln Suite 1 Breese IL 62230-3618 |
| Mailing Address |
4500 Memorial Dr Medical Affairs Credentialing Dept Belleville IL 62226-5360 |
| Practice Telephone | 6185264511 |
| Mailing Telephone | 6182574644 |
| Mailing Fax Number | 6182576946 |
| Enumeration Date | 2010-08-27 |
| 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 |
9515 HOLY CROSS LN SUITE 1 |
| City | BREESE |
| State | IL |
| Zip Code | 62230-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457319154 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | General Acute Care Hospital | 9515 Holy Cross Ln, Box 99, Breese, IL 62230-3618 | 2006-05-02 |
| 1013516897 | K and L Medical, LLC | Orthopaedic Surgery | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2020-10-22 |
| 1205469350 | St. Joseph's Hospital, Breese, of The Hospital Sisters of The Third Or | Clinic/Center | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2020-02-18 |
| 1548824592 | Dennis Joseph Riechman | Nurse Practitioner | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2019-04-25 |
| 1790349967 | Brandon Gebke | Nurse Anesthetist, Certified Registered | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2019-04-23 |
| 1447747316 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Medicare Defined Swing Bed Unit | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-04-17 |
| 1528560463 | Cep America Illinois Intensivists | Internal Medicine | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-03-07 |
| 1639678790 | Cep America-illinois Hospitalists, LLP | Internal Medicine | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-02-05 |
| 1437658622 | Cepamerica Illinois LLP | Emergency Medicine | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-02-02 |
| 1154845527 | Jeffrey Alan Wilhite | Specialist/Technologist | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2017-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841738457 | Coping 4 Kids | Social Worker | 900 N Walnut St., Breese, IL 62230 | 2017-02-02 |
| 1528505146 | Danielle Mueller | Licensed Practical Nurse | 604 North Chestnut, Breese, IL 62230 | 2017-01-20 |
| 1104000561 | Competitive Edge Sports Medicine | Family Medicine | 14160 Jamestown Rd, Breese, IL 62230 | 2007-12-20 |
| 1063606978 | Clarkson Optometry Illinois PC | Optometrist | 103 Clintonian Plaza, Breese, IL 62230 | 2007-09-04 |
| 1013002658 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Family Medicine | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2006-10-03 |
| 1730287434 | Breese Dental Group PC. | Dentist | 9437 Holy Cross Ln., Breese, IL 62230 | 2006-09-20 |
| 1144328832 | Joe Cao Truong | Dentist | 9437 Holy Cross Lane, Breese, IL 62230 | 2006-09-20 |
| 1356391155 | Timothy H Droege | Dentist | 111 North Main, Breese, IL 62230 | 2006-05-11 |
| 1346206042 | Thomas B Doyle | Radiology | 9515 Holy Cross Lane, Breese, IL 62230 | 2006-04-22 |
| 1346730561 | Amanda Walden | Nurse Practitioner | 9401 Holy Cross Ln Ste 112, Breese, IL 62230 | 2018-05-14 |
| Find all providers in zip 62230 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
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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.