OrganizationActive
Advanced Surgical Technology, LLC
NPI 1497159024 · Surgery Physician · Mount Vernon, IL
Provider details
- NPI number
- 1497159024
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sandra Adams, Office Administrator(618) 969-8317
- License
- 036115674 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
4200 Williamson Pl Ste 1a
Mount Vernon, IL 62864-6705
Phone: (618) 899-9200
Fax: (618) 899-9206
Street-level locationGet directions
Mailing address
4200 Williamson Pl Ste 1a
Mount Vernon, IL 62864-6705
Registry dates
- Enumerated
- 2014-10-10
- Last updated
- 2019-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.