SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC (NPI# 1023001377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023001377 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC |
| Practice Address |
510 Lincoln Dr Herrin IL 62948-6334 |
| Mailing Address |
600 S Cliff Ave Ste 106 Sioux Falls SD 57104-5355 |
| Practice Telephone | 6189973100 |
| Practice Fax Number | 6189973616 |
| Mailing Telephone | 6189973100 |
| Mailing Fax Number | 6189973616 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2012-10-09 |
| Authorized Official Name | MR. GREG THOMPSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6189973100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
7002421 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTHLINK | 441874 | 01 | |
| IL | BC/BS | 1458 | 01 |
| HEALTH ALLIANCE | 066440 | 01 | |
| US DEPT OF LABOR | 133621000 | 01 |
| Street Address |
510 LINCOLN DR |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-6334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629682471 | Rachel Peterson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2020-08-31 |
| 1679119572 | Marcia Skinner | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1790321602 | Braden Reeves | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1508402652 | Joshua Sheldon | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1801432968 | Sydney Allen | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1487290532 | Michelle Reed | Occupational Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1689235715 | Michelle Steh | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-06-28 |
| 1427576180 | Amelie H Wilson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2017-09-01 |
| 1790238160 | Kali Jo Moe | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2016-08-02 |
| 1336555051 | Shannon Waldon | Specialist/Technologist, Other | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2014-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134349798 | Nelson F Gauto Md PC | Clinic/Center | 3314 Patriot Court, Herrin, IL 62948 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184245375 | Specialty Surgicare, Ltd | Clinic/Center | 500 W Golf Rd Ste 102, Schaumburg, IL 60195-3503 | 2020-04-29 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1619519535 | Anderson Surgery Center LLC | Clinic/Center | 3403 Anderson Healthcare Drive, Edwardsville, IL 62025 | 2019-10-11 |
| 1922664622 | Premier Cardiac Surgery Center, LLC | Clinic/Center | 11560 S Kedzie Ave Ste 102, Merrionette Park, IL 60803-4517 | 2019-05-17 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1477017333 | Ontario Street Operatory | Clinic/Center | 22 W Ontario St, Chicago, IL 60654-5169 | 2019-01-24 |
| 1407329501 | Chicago Cosmetic Surgery Institute | Clinic/Center | 2335 S Michigan Ave, Chicago, IL 60616-2104 | 2019-01-10 |
| 1538647474 | Palos Health Surgery Center, LLC | Clinic/Center | 15300 West Ave Ste 260, Orland Park, IL 60462-4600 | 2018-08-02 |
| 1013493824 | Ann & Robert H. Lurie Children's Hospital of Chicago | Clinic/Center | 1121 Techny Rd, Northbrook, IL 60062-5503 | 2018-07-15 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.