SOUTHSIDE MEDICAL CLINIC INC


Address: 913 South 10th Street, Mount Vernon, IL 62864-5313
Phone: 6182422745

SOUTHSIDE MEDICAL CLINIC INC (NPI# 1497823314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497823314
Entity Type Organization
Organization Name SOUTHSIDE MEDICAL CLINIC INC
Practice Address 913 South 10th Street
Mount Vernon
IL 62864-5313
Practice Telephone 6182422745
Practice Fax Number 6182422766
Mailing Telephone 6182422745
Mailing Fax Number 6182422766
Enumeration Date 2006-11-30
Last Update Date 2020-08-22
Authorized Official Name BRUCE WAYNE MELVIN (EXECUTIVE DIRECTOR)
Authorized Official Telephone 6182422745
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
=========001 IL Ambulatory Health Care Facilities

Office Location

Street Address 913 SOUTH 10TH STREET
City MOUNT VERNON
State IL
Zip Code 62864-5313

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619438892 Melissa Pryer Dietitian, Registered 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 2019-03-28
1487145454 Chiropractic Wellness Center of Mt Vernon, LLC. Chiropractor 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 2018-05-24
1851889208 Kimberly Tate Counselor 4110 North Water Place, Mt. Vernon, IL 62864 2018-05-01
1871907790 University Hematology Oncology Inc Specialist #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 2014-06-18
1457771677 Dynamic Counseling and Consultation Services Social Worker 3600 S Water Tower Pl, Mt Vernon, IL 62864 2014-04-27
1619239431 Judith C Morgan Counselor 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 2012-06-08
1073888624 James Brian Verges Counselor 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 2012-03-15
1720352271 Lucinda M. Holdren Counselor 16338 North Illinois Highway 37, Mount Vernon, IL 62864 2012-03-01
1780978627 Jamie M Orange Physical Therapy Assistant 19958 Fairfield Rd, Mt. Vernon, IL 62864 2011-06-08
1780978791 Wendy Marie Claytor Speech-Language Pathologist 600 E Il Hwy 15, Mount Vernon, IL 62864 2011-06-07
Find all providers in zip 62864

Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396263000 Rockcastle County Hospital, Inc. Clinic/Center 1770 Lake Cumberland Rd, Mount Vernon, KY 40456-8431 2017-09-01
1578090403 Advanced Family Medical Clinic Mount Vernon Clinic/Center 50 Lovell Court, Mount Vernon, KY 40456-2964 2017-05-23
1306114004 Lower Oconee Community Hospital, Inc Clinic/Center 421 W Robinson Dr, Mount Vernon, GA 30445-2935 2011-12-08
1871706374 John Hall Md Rural Health Services Clinic/Center 3505 Broadway St Ste A, Mount Vernon, IL 62864-2202 2007-05-08
1164547287 Lower Oconee Community Hospital, Inc Clinic/Center 441 W Broad Street, Mount Vernon, GA 30445-2629 2007-03-20
1669466686 Crossroads Physician Corp Clinic/Center 3505 Broadway St, Mount Vernon, IL 62864-2202 2005-09-06
1548264237 Physician Services Corp of Southern Illinois Clinic/Center 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 2005-06-09
1912900234 Family Care Network, Pllc Clinic/Center 2116 E. Section St., Mount Vernon, WA 98274 2005-05-31
1447814405 National Healthcare of Mt Vernon Inc Clinic/Center 4101 N Water Tower Pl, Mount Vernon, IL 62864-6296 2019-04-25
1801280409 Heartland Women's Healthcare, Ltd Clinic/Center 3130 Veterans Memorial Dr, Mount Vernon, IL 62864-5951 2015-03-23
Find all providers in MOUNT VERNON

Competitor

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City MOUNT VERNON
Zip Code 62864

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Dataset Information

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.

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