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

Individual provider Surgical Physician Assistant · NPI 1932322815

Kelly Ambrosius, CST, CFA, RSA is a Surgical Physician Assistant in Wadsworth, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
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Practice location Address checks out

39067 N Caroline Ave #362
Wadsworth, IL 60083-7728
Phone: (800) 560-8374
Fax: (800) 560-8374
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 238.00009 (IL)

Record details

NPI number1932322815
Entity typeIndividual (Type 1)
GenderMale
Credentials CST , CFA , RSA
Sole proprietorNo
NPI enumeratedApril 10, 2007
Last updated in NPPESApril 1, 2015