Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fairview Heights Medical Group SC

Organization Urology Physician · NPI 1417140609

Fairview Heights Medical Group SC is an Urology Physician in Edwardsville, Illinois. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

8 Sunset Hills Professional Ctr
Edwardsville, IL 62025-3760
Phone: (618) 692-9828
Fax: (618) 692-7337
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X

Record details

NPI number1417140609
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raymond Davidson — President · (314) 286-2028
Other names Alton Urological Associates Edwardsville
NPI enumeratedAugust 22, 2007
Last updated in NPPESJanuary 7, 2008
Mailing address670 Mason Ridge Center Dr, Suite 300, Saint Louis, MO 63141-8573