DR. SHAHEDA M MANSURI (NPI# 1598701401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598701401 |
| Entity Type | Individual |
| Full Name | DR. SHAHEDA M MANSURI |
| Credential | MD |
| Practice Address |
1564 S Washington St Du Quoin IL 62832-3849 |
| Mailing Address |
Po Box 155 Christopher IL 62822-0155 |
| Practice Telephone | 6185428702 |
| Mailing Telephone | 6187241624 |
| Mailing Fax Number | 6187244628 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 036070613 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2401 W Main St, Vamedical Center, Marion, IL 629591188 | 6189934183 | 6189985677 |
| Street Address |
1564 S WASHINGTON ST |
| City | DU QUOIN |
| State | IL |
| Zip Code | 62832-3849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619957297 | Christopher Greater Area Rural Health Planning Corporation | Counselor | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2006-01-19 |
| 1710516604 | Gorana Micevic | Physician Assistant | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2020-04-03 |
| 1497238612 | Macie M Clark | Licensed Practical Nurse | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2018-09-13 |
| 1386123347 | Teresa Mcbride | Licensed Practical Nurse | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2018-08-10 |
| 1932692852 | Rebecca Loucks | Registered Nurse | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2018-06-14 |
| 1194064774 | Margaret Ann Howard | Social Worker | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2013-02-03 |
| 1881906055 | Jeri Lynn Brinkley | Physician Assistant | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2010-07-05 |
| 1275854853 | Benjamin Rathert | Family Medicine | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2010-06-17 |
| 1194988493 | Michael H Poiter | Physician Assistant | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2008-07-07 |
| 1508960915 | Tamara Collard | Physician Assistant | 1564 S Washington St, Du Quoin, IL 62832-3849 | 2006-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336618859 | Jarrett Alexander Edwards | Pharmacist | 215 Grant Way Wal Mart Pharmacy, Du Quoin, IL 62832 | 2018-11-14 |
| 1932687944 | Gold Plate Program of Perry County | In Home Supportive Care | 721 N Hickory St, Du Quoin, IL 62832 | 2018-08-01 |
| 1972833770 | Danielle Klump | Nurse Practitioner | 900 N Washington Street, Du Quoin, IL 62832 | 2009-12-30 |
| 1003017849 | Heather Richelman | Physical Therapist | 900 N. Washington, Duquoin, IL 62832 | 2007-05-30 |
| 1295954600 | Duquoin Comm Unit Dist 300 | Clinic/Center | 845 East Jackson Street, Duquoin, IL 62832 | 2007-04-24 |
| 1427106426 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | Us Hwy 51 S Rr 2, Duquion, IL 62832 | 2007-01-08 |
| 1659475879 | Southern Illinois Surgical Appliance Co | Durable Medical Equipment & Medical Supplies | 207 East Main St, Duquoin, IL 62832 | 2006-09-08 |
| 1801909700 | Edward Clay Travis | Family Medicine | 900 N. Washington St, Du Quoin, IL 62832 | 2006-08-16 |
| 1871505941 | John Wesley Melvin | Chiropractor | 420 South Washington St, Duquoin, IL 62832 | 2006-08-13 |
| 1730133505 | Patrick L Riley | Family Medicine | 119 Gas Plant Road, Rea Clinic Duquoin, Duquoin, IL 62832 | 2006-05-19 |
| Find all providers in zip 62832 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831414531 | Raghuveer M. Kudva | General Practice | 960 South Lake Drive, Du Quoin, IL 62832-2448 | 2010-04-06 |
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| 1447881487 | Tyrian Healthcare Solutions, LLC | General Practice | 2120 W Heading Ave, West Peoria, IL 61604-5138 | 2020-01-29 |
| 1598302077 | Enhance Medical LLC | General Practice | 1193 N Gary Ave, Carol Stream, IL 60188-9423 | 2019-12-04 |
| 1164067054 | League Corp. | General Practice | 515 N State St Fl 8, Chicago, IL 60654-9102 | 2019-11-14 |
| 1679129977 | Chronic Care Solutions LLC | General Practice | 3050 W Columbia Ave, Chicago, IL 60645-4006 | 2019-08-13 |
| 1205393972 | Midwest Medical LLC | General Practice | 2001 Midwest Rd Ste Ll22, Oak Brook, IL 60523-1316 | 2019-02-28 |
| 1306311725 | Genesis Integrative Medicine LLC | General Practice | 1881 S Randall Rd Ste C, Geneva, IL 60134-2532 | 2018-10-11 |
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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.