Provider Demographics
NPI:1558930396
Name:UNITED SURGICAL INSTITIUTE, PLLC
Entity Type:Organization
Organization Name:UNITED SURGICAL INSTITIUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-239-0678
Mailing Address - Street 1:741 INSIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-2193
Mailing Address - Country:US
Mailing Address - Phone:618-239-0678
Mailing Address - Fax:800-516-2392
Practice Address - Street 1:741 INSIGHT AVE
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-2193
Practice Address - Country:US
Practice Address - Phone:618-239-0678
Practice Address - Fax:800-516-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty