MICHAEL AMBROSE (NPI# 1538398680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538398680 |
| Entity Type | Individual |
| Full Name | MICHAEL AMBROSE |
| Credential | MD |
| Practice Address |
605 N 12th St Mount Vernon IL 62864 |
| Mailing Address |
5036 N Illinois St Ste 1 Fairview Heights IL 62208-3418 |
| Practice Telephone | 6182412212 |
| Practice Fax Number | 6182412508 |
| Mailing Telephone | 6186716800 |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2018-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 038010043 | IL | Chiropractic Providers |
| Y | 207R00000X | Internal Medicine | 036128279 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 605 N 12th St, Mount Vernon, IL 628642857 | 6182412212 | 6182412508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144661 | Michael Ambrose | Psychologist | 1 Park Ave Fl 7, New York, NY 10016-5818 | 2020-05-06 |
| 1548829542 | Michael Ambrose | Student in an Organized Health Care Education/Training Program | 170 Manning Drive, Chapel Hill, NC 27599-1178 | 2019-06-12 |
| 1669793154 | Michael Ambrose | Pediatrics | 5301 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2010-06-18 |
| 1922169713 | Michael Frank Ambrose | Optometrist | 61 Talsman Dr, Canfield, OH 44406-1207 | 2006-12-13 |
| 1841222403 | Michael F Ambrose | Family Medicine | 701 Medical Park Dr, Suite 302/303, Hartsville, SC 29550-4777 | 2006-07-06 |
| 1538199526 | Michael Patrick Ambrose | Audiologist | 1005a E Commercial Blvd, Oakland Park, FL 33334-3956 | 2006-07-04 |
| 1427023696 | Michael Rainer Ambrose | Emergency Medicine | 2451 Fillingim St, Suite 10 L, Mobile, AL 36617-2238 | 2006-02-21 |
| Street Address |
605 N 12TH ST |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447266507 | Prince B Oliver Jr. | Anesthesiology | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2006-07-31 |
| 1629367578 | Midwest Emergency Good Samaritan, Inc | Emergency Medicine | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2011-03-31 |
| 1528394335 | Katelyn Marie Lewis | Speech-Language Pathologist | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2009-10-29 |
| 1295975837 | Sterling Emergency Physicians of Illinois, S.c | Physician Assistant | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2009-02-23 |
| 1316108970 | Zachary R Gustavison | Physician Assistant | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2008-06-17 |
| 1871773879 | Thomas J. Cain | Nurse Anesthetist, Certified Registered | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-11-07 |
| 1508063405 | Advanced Internal Medicine, LLC | Internal Medicine | 605 N 12th St, Hospitalist Office, Mount Vernon, IL 62864-2857 | 2007-07-02 |
| 1215142310 | Douglas Elner Frankel | Emergency Medicine | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-05-11 |
| 1659416923 | Amanda M Brown | Physical Therapist | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-02-21 |
| 1184769465 | Justine Thole | Speech-Language Pathologist | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912359332 | Narasimha Rao Vattikunta | Internal Medicine | 41 W Sidney Ave, Mount Vernon, Mount Vernon, NY 10550-1954 | 2016-07-09 |
| 1477968337 | Navdeep Dhaliwal | Internal Medicine | 1415 E Kincaid St Dept Of, Mount Vernon, WA 98274-4126 | 2014-06-30 |
| 1043579527 | Maruti Sharma | Internal Medicine | 105 Stevens Ave Ste 208, Mount Vernon, NY 10550 | 2012-05-03 |
| 1235309527 | Mohamed Ruzaik Ibrahim | Internal Medicine | 4115 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2008-03-03 |
| 1699970202 | Michael Finkelstein, M.d | Internal Medicine | 12 N 7th Ave Fl 5, Mount Vernon, NY 10550-2026 | 2007-06-15 |
| 1801962709 | Carl Joseph Dangio | Internal Medicine | 395 Westchester Avenue, Private House, Mount Vernon, NY 10552-3012 | 2006-11-24 |
| 1629149562 | Manzoor Bhatti | Internal Medicine | 445 Gramatan Ave, Mount Vernon, NY 10552-2931 | 2006-11-13 |
| 1972684173 | Robert Edward Rodstrom | Internal Medicine | 1451 Yauger Rd. 1f, Mount Vernon, OH 43050 | 2006-10-17 |
| 1477656304 | Mark D. Baldwin | Internal Medicine | 819 South 13th Street, Mount Vernon, WA 98273 | 2006-09-06 |
| 1760499594 | Shailesh C Patel | Internal Medicine | 812 Coshocton Avenue, Mount Vernon, OH 43050 | 2006-08-02 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.