OrganizationActive
Msa Alliance, LLC
NPI 1255647228 · Vascular Surgery Physician · Breese, IL
Provider details
- NPI number
- 1255647228
- Entity type
- Organization
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Msa Alliance, LLC
- Organization subpart
- Yes
- Authorized official
- James Davis, Executive Director(618) 257-4644
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9515 Holy Cross Ln
Suite 1
Breese, IL 62230-3618
Phone: (618) 526-4511
Street-level locationGet directions
Mailing address
4500 Memorial Dr
Belleville, IL 62226-5360
Registry dates
- Enumerated
- 2010-08-27
- Last updated
- 2013-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.