Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY AMBROSIUS, CST,CFA,RSA
ActiveKELLY AMBROSIUS, CST,CFA,RSA is a Surgical Physician Assistant healthcare provider located in WADSWORTH, Illinois. NPI 1932322815 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · WADSWORTH, IL
Registration Details
- NPI Number
- 1932322815
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 10, 2007 (19.354547213056 yrs)
- Last Updated
- Apr 1, 2015
- License
-
238.00009 (IL)
Practice Information
- Address
-
39067 N CAROLINE AVE#362WADSWORTH, IL, 600837728Browse IL providers · Browse ZIP 60083
- Phone
- 8005608374
- Fax
- 8005608374
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.