SIU PHYSICIANS & SURGEONS, INC (NPI# 1558385989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558385989 |
| Entity Type | Organization |
| Organization Name | SIU PHYSICIANS & SURGEONS, INC |
| Practice Address |
201 E Madison St Ste 300 Springfield IL 62702-5131 |
| 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 | 2020-02-17 |
| Authorized Official Name | CHERI DOOLIN (CREDENTIALING SERVICES SPECIALIST) |
| Authorized Official Telephone | 2175453787 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | ========= | IL | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | ========= | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | ========= | IL | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | ========= | IL | Allopathic & Osteopathic Physicians |
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
========= | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | CE8688 | 01 |
| IL | RR MEDICARE | CE8689 | 01 |
| IL | RR MEDICARE | CE8687 | 01 |
| IL | RR MEDICARE | CE8931 | 01 |
| IL | RR MEDICARE | CB2589 | 01 |
| IL | RR MEDICARE | CE8686 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1467476895 | Siu Physicians & Surgeons, Inc | Counselor | 701 N 1st St, D235, Springfield, IL 62781-0001 | 2006-07-27 |
| Street Address |
201 E MADISON ST STE 300 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-5131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396211975 | Siu Physicians & Surgeons, Inc | Case Management | 201 E Madison St Ste 300, Springfield, IL 62702-5131 | 2018-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1710243621 | Michele A Gortakowski | Internal Medicine | 3300 Main St Fl 3, Springfield, MA 01107-1112 | 2012-04-04 |
| 1538319447 | Joy Debbie Sudler | Internal Medicine | 28 Cottage Ln, Springfield, NJ 07081-2303 | 2008-09-27 |
| 1295714657 | Catherine M Hegarty | Internal Medicine | 2150 Main Street, Springfield, MA 01104 | 2006-01-13 |
| 1174510978 | Marina K Russo | Internal Medicine | 1118 Legacy Pointe Dr, Springfield, IL 62711 | 2005-10-05 |
| 1124023726 | Linda R. Macgorman | Internal Medicine | 960 E Walnut Lawn, Suite 201, Springfield, MO 65807 | 2005-06-20 |
| 1871948414 | Prospect Health Access Network, Inc. | Internal Medicine | 190 W Sproul Rd, Suite 102, Springfield, PA 19064-2027 | 2016-05-02 |
| 1467894527 | Sanober Parveen | Internal Medicine | 751 N Rutledge St Ste 1700, Springfield, IL 62702-4968 | 2013-07-17 |
| 1811338841 | Mariam Murtaza Ali | Internal Medicine | 751 N Rutledge St Ste 1700, Springfield, IL 62702-4968 | 2013-07-05 |
| 1316382823 | Cecilia A Davis | Internal Medicine | 3300 Main Street, Springfield, MA 01107-1112 | 2013-05-10 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on SIU PHYSICIANS & SURGEONS, INC.
| 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.