SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC (NPI# 1508953746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508953746 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC |
| Practice Address |
4600 Memorial Drive Suite 340 Belleville IL 62226 |
| Mailing Address |
P.o. Box 23620 Belleville IL 62223-0620 |
| Practice Telephone | 6182229999 |
| Practice Fax Number | 6182229337 |
| Mailing Telephone | 6182229999 |
| Mailing Fax Number | 6182229337 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | REBECCA J TIBEREND (BILLING OFFICER SUPERVISOR) |
| Authorized Official Telephone | 6182229999 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Street Address |
4600 MEMORIAL DRIVE SUITE 340 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013901487 | Pc Associates,llc | Family Medicine | 4600 Memorial Drive, Ste. 220, Belleville, IL 62226 | 2005-08-31 |
| 1356632186 | Ca Group, LLC | Internal Medicine | 4600 Memorial Drive, Suite W-1, Belleville, IL 62226 | 2011-04-27 |
| 1629386586 | Ob Practice, LLC | Obstetrics & Gynecology | 4600 Memorial Drive, Ste. 400, Belleville, IL 62226 | 2010-09-14 |
| 1689997280 | Ca Group LLC | Internal Medicine | 4600 Memorial Drive, Ste. W-1, Belleville, IL 62226 | 2010-03-10 |
| 1265608251 | Renee Lynne Davis | Nurse Practitioner | 4600 Memorial Drive, Suite G60, Belleville, IL 62226-5366 | 2008-04-30 |
| 1407021504 | Valerie J Griffin | Nurse Practitioner | 4600 Memorial Drive, Suite G60, Belleville, IL 62226-5366 | 2008-04-29 |
| 1588704613 | Orthopedic and Sports Medicine Physicians, Ltd | Specialist | 4600 Memorial Drive, Suite 200, Belleville, IL 62226 | 2007-02-07 |
| 1205905197 | Khai Ngo | Pediatrics | 4600 Memorial Drive, Suite 280, Belleville, IL 62276-5366 | 2006-11-07 |
| 1376630103 | Southern Illinois Internal Medicine Ltd | Internal Medicine | 4600 Memorial Drive, Suite 310, Belleville, IL 62226-5366 | 2006-10-05 |
| 1306871660 | David Craig Norman | Pediatrics | 4600 Memorial Drive, Medical Office Center #2 Suite G60, Belleville, IL 62226-5366 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| 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 |
|---|---|---|---|---|
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1083988380 | Southern Illinois Endoscopy | Internal Medicine | 2810 Frank Scott Parkway, Suite 716, Belleville, IL 62223-6802 | 2012-03-05 |
| 1982852471 | Harry M Friedland, Md Pa | Internal Medicine | 5 Franklin Ave. Ste 307, Belleville, NJ 07109 | 2008-09-09 |
| 1558553024 | Vasantha Pai M.d. P.C. | Internal Medicine | 300 W Lincoln St Ste 302, Belleville, IL 62220-1987 | 2007-08-17 |
| 1861548869 | Robert D Fricke Md | Internal Medicine | 300 W Lincoln St Ste 400, Belleville, IL 62220-1987 | 2007-01-25 |
| 1306921218 | Vasantha P Pai | Internal Medicine | 2810 Frank Scott Pkwy W Ste 716, Belleville, IL 62223-5007 | 2006-10-26 |
| 1407951478 | Stephen A. Schmidt Md Sc | Internal Medicine | 300 W Lincoln St, Belleville, IL 62220-1987 | 2006-09-14 |
| 1356377816 | Yazan A Abu Qwaider | Internal Medicine | 4600 Memorial Dr Ste 260, Belleville, IL 62226-5363 | 2006-06-24 |
| 1548773294 | Msa Alliance | Internal Medicine | 4600 Memorial Dr Ste 260, Belleville, IL 62226-5363 | 2017-11-15 |
| 1447590328 | Metro East Gastroenterology Ltd. | Internal Medicine | 311 W Lincoln St Ste 101, Belleville, IL 62220-1902 | 2013-02-28 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
Please comment or provide details below to improve the information on SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC.
| 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.