SOUTHERN ILLINOIS GI SPECIALISTS LLC (NPI# 1093775405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093775405 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS GI SPECIALISTS LLC |
| Practice Address |
1100 W Diann Ln Carbondale IL 62901-5339 |
| Mailing Address |
Po Box 365 Carbondale IL 62903-0365 |
| Practice Telephone | 6185498006 |
| Practice Fax Number | 6185498434 |
| Mailing Telephone | 6184769399 |
| Mailing Fax Number | 6184769547 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2008-08-12 |
| Authorized Official Name | ZAHOOR A MAKHDOOM (MD OWNER) |
| Authorized Official Telephone | 6185498006 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036094155 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036094155 | 05 | |
| IL | BCBS IL | 03926864 | 01 |
| HEALTH ALLIANCE HMO | 063398 | 01 | |
| HEALTHLINK | 435384 | 01 |
| Street Address |
1100 W DIANN LN |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-5339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407366123 | Ariele N. Loiacono | Nurse Practitioner | 1100 W Diann Ln, Carbondale, IL 62901-5339 | 2017-10-08 |
| 1982667309 | Zahoor A Makhdoom | Internal Medicine | 1100 W Diann Ln, Carbondale, IL 62901-5339 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619019304 | Michael Maitar | Internal Medicine | 2601 W Main St, Carbondale, IL 62901 | 2007-02-12 |
| 1356355135 | Sheffield Boardman | Internal Medicine | 2601 W Main St, Carbondale, IL 62901-1031 | 2006-07-28 |
| 1982667309 | Zahoor A Makhdoom | Internal Medicine | 1100 W Diann Ln, Carbondale, IL 62901-5339 | 2006-04-07 |
| 1821065392 | Nader J Dababneh | Internal Medicine | 2601 W Main St, Carbondale, IL 62901-1031 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013487388 | Endoscopy Center of The North Shore, LLC | Internal Medicine | 1100 Central Ave Ste H, Wilmette, IL 60091-2666 | 2018-11-29 |
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1861999559 | Kiba, Inc. | Internal Medicine | 3845 Mccoy Dr Ste 101, Aurora, IL 60504-4429 | 2018-04-09 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1699186890 | Laura Hamad | Internal Medicine | 1717 Midwest Club Pkwy, Oak Brook, IL 60523-2586 | 2014-05-11 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1841533254 | Danish Shahab | Internal Medicine | 133 E Brush Hill Rd Ste 100&400, Elmhurst, IL 60126-5659 | 2013-04-03 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.