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Organization

King City Physician Company, LLC

NPI Record: ActiveOtolaryngology — Plastic Surgery within the Head & Neck
NPI1134470859
Mount Vernon, Illinois

Provider's NPPES record last updated: July 7, 2023

Overview

Entity Type
Organization
NPI
1134470859
Primary Specialty
Otolaryngology — Plastic Surgery within the Head & Neck
Practice Location
Mount Vernon, Illinois
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 19, 2026, 9:28 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Otolaryngology

    Plastic Surgery within the Head & Neck

    Allopathic & Osteopathic Physicians

    Primary

    An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

    Taxonomy code 207YX0007X
  • Family Medicine

    Allopathic & Osteopathic Physicians

    Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

    Taxonomy code 207Q00000X
  • Internal Medicine

    Allopathic & Osteopathic Physicians

    A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

    Taxonomy code 207R00000X
  • Internal Medicine

    Cardiovascular Disease

    Allopathic & Osteopathic Physicians

    An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

    Taxonomy code 207RC0000X
  • Internal Medicine

    Pulmonary Disease

    Allopathic & Osteopathic Physicians

    An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

    Taxonomy code 207RP1001X
  • Pediatrics

    Adolescent Medicine

    Allopathic & Osteopathic Physicians

    A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

    Taxonomy code 2080A0000X
  • Surgery

    Allopathic & Osteopathic Physicians

    A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

    Taxonomy code 208600000X
  • Urology

    Allopathic & Osteopathic Physicians

    A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

    Taxonomy code 208800000X
  • Physician Assistant

    Physician Assistants & Advanced Practice Nursing Providers

    A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

    Taxonomy code 363A00000X
  • Nurse Practitioner

    Family

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 363LF0000X

Practice Locations

Practice Location

4117 S Water Tower Pl

Suite C

Mount Vernon, Illinois 62864-6567

Phone: (618) 242-0672

Record Information

Enumeration Date
September 20, 2012
Provider's NPPES Record Last Updated
July 7, 2023
Certification Date
July 7, 2023
NPISignal NPPES Dataset
August 2026

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