SIU PHYSICIANS & SURGEONS, INC. (NPI# 1508924093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508924093 |
| Entity Type | Organization |
| Organization Name | SIU PHYSICIANS & SURGEONS, INC. |
| Other Organization Name | SOUTHERN ILLINOIS FAMILY MEDICINE |
| Practice Address |
305 W Jackson St Suite 200 Carbondale IL 62901-1474 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 6184533777 |
| Practice Fax Number | 6184531102 |
| Mailing Telephone | 2175457578 |
| Mailing Fax Number | 2175451884 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | MR. NELSON C WEICHOLD (CFO) |
| Authorized Official Telephone | 2175457578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
========= | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SOUTHERN ILLINOIS FAMILY MEDICINE | Doing Business As Name - Organization |
| Street Address |
305 W JACKSON ST SUITE 200 |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596726 | John Ward Watson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 305 W Jackson St, Suite 105, Carbondale, IL 62901-1474 | 2005-05-24 |
| 1780034926 | Ahmed Sharif | Family Medicine | 305 W Jackson St, Carbondale, IL 62901-1474 | 2016-06-19 |
| 1548619406 | Jordan Wood | Family Medicine | 305 W Jackson St, Carbondale, IL 62901-1474 | 2016-06-10 |
| 1225499825 | Ashley Nicole Freeman | Nurse Practitioner | 305 W Jackson St, Ste 103, Carbondale, IL 62901 | 2016-03-10 |
| 1548625460 | Kasia Schaefer | Physical Medicine & Rehabilitation | 305 W Jackson St, Carbondale, IL 62901-1474 | 2015-12-18 |
| 1770966137 | Pamela Renee Milano | Family Medicine | 305 W Jackson St, Ste 200, Carbondale, IL 62901-1474 | 2015-07-02 |
| 1215319140 | Gritz Pierre | Family Medicine | 305 W Jackson St, 200, Carbondale, IL 62901-1474 | 2015-06-27 |
| 1154702116 | Nabeel Mohammed Siddiqui | Family Medicine | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2015-06-16 |
| 1992196752 | New Horizons Medical Associates, LLC | Obstetrics & Gynecology | 305 W Jackson St, Suite 100, Carbondale, IL 62901-1474 | 2015-02-13 |
| 1255747002 | Fariha Rub | Family Medicine | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2014-07-01 |
| Find all providers in the same location | ||||
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
| 1154510808 | Southern Illinois Medical Services, Nfp | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2007-10-18 |
| 1417013095 | Carbondale Rural Health Clinic | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2006-12-28 |
| 1215978127 | Board of Trustees of Southern Illinois University | Clinic/Center | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
| 1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
| 1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
| 1821561895 | Heartland Women's Healthcare Ltd | Clinic/Center | 215 N Logan St Ste A, West Frankfort, IL 62896-2314 | 2019-01-02 |
| 1578040275 | Osf Healthcare System | Clinic/Center | 230 S Exchange St, Galva, IL 61434-1871 | 2018-07-25 |
| 1700380219 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1510 W Springfield Rd Ste A, Taylorville, IL 62568-2764 | 2018-03-20 |
| 1326542903 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1001 Avenue of Mid America Ste 4, Effingham, IL 62401-4634 | 2018-03-20 |
| 1649795659 | Harrisburg Medical Center Inc | Clinic/Center | 3106 Outer Dr Ste 200, Marion, IL 62959-5270 | 2017-08-10 |
| 1588186308 | Wabash General Hospital District | Clinic/Center | 1430 College Dr Ste A, Mount Carmel, IL 62863-2649 | 2017-07-13 |
| 1356884993 | Gibson Community Hospital Association | Clinic/Center | 510 Prairie Ln Unit B, Cissna Park, IL 60924-9710 | 2016-11-30 |
| 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.