SIU PHYSICIANS & SURGEONS, INC (NPI# 1467476895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467476895 |
| Entity Type | Organization |
| Organization Name | SIU PHYSICIANS & SURGEONS, INC |
| Practice Address |
701 N 1st St D235 Springfield IL 62781-0001 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2175457578 |
| Practice Fax Number | 2175451884 |
| Mailing Telephone | 2175457578 |
| Mailing Fax Number | 2175451884 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | DAVID TKACH (CEO) |
| Authorized Official Telephone | 2175457578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
========= | IL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
========= | IL | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | ========= | IL | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | ========= | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
========= | IL | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
========= | IL | Behavioral Health & Social Service Providers |
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
========= | IL | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
========= | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | CE8687 | 01 |
| IL | RR MEDICARE | CE8688 | 01 |
| IL | RR MEDICARE | CE8686 | 01 |
| IL | RR MEDICARE | CE8689 | 01 |
| IL | RR MEDICARE | CB2589 | 01 |
| IL | RR MEDICARE | CE8931 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558385989 | Siu Physicians & Surgeons, Inc | Dermatology | 201 E Madison St Ste 300, Springfield, IL 62702-5131 | 2006-07-27 |
| 1790705507 | Siu Physicians & Surgeons, Inc | Orthopaedic Surgery | 720 N Bond St, Springfield, IL 62702-4952 | 2006-07-21 |
| 1164055976 | Siu Physicians & Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 747 N Rutledge St Fl 5, Springfield, IL 62702-6700 | 2020-02-20 |
| 1942849096 | Siu Physicians & Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 720 N Bond St, Springfield, IL 62702-4952 | 2020-01-06 |
| 1396211975 | Siu Physicians & Surgeons, Inc | Case Management | 201 E Madison St Ste 300, Springfield, IL 62702-5131 | 2018-10-22 |
| 1053804443 | Siu Physicians & Surgeons, Inc | Clinic/Center | 610 N Westgate Ave, Jacksonville, IL 62650-1152 | 2018-06-11 |
| 1457807869 | Siu Physicians & Surgeons, Inc | Clinic/Center | 608 S Main St, Anna, IL 62906-1247 | 2016-08-27 |
| 1871882787 | Siu Physicians & Surgeons, Inc | Internal Medicine | 315 W Carpenter St, Springfield, IL 62702-4901 | 2011-03-31 |
| 1821290057 | Siu Physicians & Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 747 N Rutledge St, 3rd Floor, Springfield, IL 62702-6700 | 2007-06-01 |
| 1093739435 | Siu Physicians & Surgeons, Inc | Family Medicine | 701 N 1st St, D235, Springfield, IL 62781-0001 | 2006-07-27 |
| Street Address |
701 N 1ST ST D235 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62781-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607123 | Memorial Home Services | Home Health | 701 N 1st St, Springfield, IL 62781-4952 | 2005-05-23 |
| 1316552524 | Mary Ann Seagle | Nurse Practitioner | 701 N 1st St, Springfield, IL 62781-0001 | 2020-09-14 |
| 1497372361 | Amir Mcphearson | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-26 |
| 1508482597 | Kirsten Kay Carew | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-25 |
| 1699391482 | Aruya Davis | Registered Nurse | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-17 |
| 1497370852 | Alyssa Rose Jimerson | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-11 |
| 1649895038 | Elisha Boyd | Nurse Practitioner | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-10 |
| 1275158990 | Ashley L Mcgrath | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-09 |
| 1205451812 | Christopher Evan Bejcek | Orthopaedic Surgery | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-09 |
| 1912521790 | Neil Carter Parker | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104145747 | Justin Neil Henry | Hospitalist | 701 N 1st St Rm B146, Springfield, IL 62781 | 2010-05-21 |
| 1457464208 | Edward J Ryan Poje | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| 1649285453 | Sanjai Nagendra | Pathology | 701 N First Street, Springfield, IL 62781 | 2006-07-30 |
| 1770518706 | Daniel L Stanton Jr. | Radiology | 701 N. First St, Springfield, IL 62781 | 2006-07-11 |
| 1497914741 | Ted Robert Clark | Emergency Medicine | 701 N. 1st Street, Springfield, IL 62781 | 2008-06-03 |
| 1851486393 | Joan Lewis | Nurse Practitioner | 701 N First St, Springfield, IL 62781 | 2006-10-03 |
| 1548363138 | Pathology Associates of Central Illinois Ltd | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-09-07 |
| 1962511931 | Chad Joseph Defrain | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1346359320 | Nassim Banisaeed | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1922111772 | John E Murphy | Pathology | 701 N First Street, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| Find all providers in zip 62781 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1316441470 | Earl Randolph Hackett | Psychiatry & Neurology | 2517 S. Brentwood, Springfield, MO 65804-3201 | 2018-03-22 |
| 1336668326 | Western Mass Neurology PC | Psychiatry & Neurology | 175 Carew St Ste 140, Springfield, MA 01104-2389 | 2017-09-12 |
| 1407111313 | Pavan Tummala | Psychiatry & Neurology | 3800 S National Ave Ste 900, Springfield, MO 65807-5209 | 2012-07-06 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1053553560 | Quantum Total Health | Psychiatry & Neurology | 607 S Locust St, Springfield, TN 37172 | 2009-03-30 |
| 1154513687 | Fazeel Mukhtar Siddiqui | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2007-08-17 |
| 1164593646 | Michael Balm | Psychiatry & Neurology | 1 Hayden Bridge Way Ste 410, Springfield, OR 97477-1347 | 2006-11-13 |
| 1881638591 | Rodney D Quinn | Psychiatry & Neurology | 3801 S National Ave # 900, Springfield, MO 65807-5210 | 2006-06-15 |
| 1750332771 | Sleep Medicine Services of Western Massachusetts LLC | Psychiatry & Neurology | 3640 Main St Ste 208, Springfield, MA 01107-1192 | 2006-05-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62781 |
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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.