SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (NPI# 1750705364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750705364 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP |
| Other Organization Name | PRIMARY CARE GROUP |
| Practice Address |
117 E Clark St Harrisburg IL 62946-2702 |
| Practice Telephone | 6182528625 |
| Practice Fax Number | 6182522540 |
| Mailing Telephone | 6182528625 |
| Mailing Fax Number | 6182522540 |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-02-18 |
| Authorized Official Name | REX P BUDDE (CEO/PRESIDENT) |
| Authorized Official Telephone | 6184575200 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN ILLINOIS HOSPITAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
036042756 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Primary Care Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841614633 | Southern Illinois Medical Services, Nfp | Clinic/Center | 7211 Us 45 S Ste C, Carrier Mills, IL 62917-1305 | 2014-02-13 |
| 1538689062 | Southern Illinois Medical Services, Nfp | Clinic/Center | 98 Peach Ridge Rd, Anna, IL 62906-2243 | 2017-06-26 |
| 1477820900 | Southern Illinois Medical Services, Nfp | Clinic/Center | 405 Rushing Dr, Herrin, IL 62948-3730 | 2011-11-29 |
| 1215204938 | Southern Illinois Medical Services, Nfp | Clinic/Center | 502 W St Louis, West Frankfort, IL 62896-1968 | 2011-11-23 |
| 1780985135 | Southern Illinois Medical Services, Nfp | Clinic/Center | 203 Bailey Ln, Suite 1, Benton, IL 62812-1969 | 2010-11-16 |
| 1992032809 | Southern Illinois Medical Services, Nfp | Clinic/Center | 19 E Shawnee Dr, Suite 2, Murphysboro, IL 62966-7071 | 2009-11-13 |
| 1982845137 | Southern Illinois Medical Services, Nfp | Clinic/Center | 203 Bailey Ln, Benton, IL 62812-1969 | 2009-03-18 |
| 1154510808 | Southern Illinois Medical Services, Nfp | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2007-10-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP | 2601 W Main St, Carbondale, IL 62901-1031 |
| Street Address |
117 E CLARK ST |
| City | HARRISBURG |
| State | IL |
| Zip Code | 62946-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265419261 | Harrisburg Family Practice Ltd | Family Medicine | 117 E Clark St, Harrisburg, IL 62946-2702 | 2005-12-30 |
| 1033737259 | Joseph Baxter | Physical Therapist | 117 E Clark St, Harrisburg, IL 62946-2702 | 2020-07-14 |
| 1104327824 | Katherine Emily Jones | Social Worker | 117 E Clark St, Harrisburg, IL 62946-2702 | 2018-02-27 |
| 1447767603 | Anne Melinda Clayton | Social Worker | 117 E Clark St, Harrisburg, IL 62946 | 2018-01-09 |
| 1891209912 | Amanda Jo Brown | Nurse Practitioner | 117 E Clark St, Harrisburg, IL 62946-2702 | 2017-11-28 |
| 1760831218 | Jason West | Family Medicine | 117 E Clark St, Harrisburg, IL 62946 | 2016-06-06 |
| 1104109024 | Dianna Questelle | Massage Therapist | 117 E Clark St, Harrisburg, IL 62946-2702 | 2011-09-27 |
| 1386931590 | Megan Hoffman | Nurse Practitioner | 117 E Clark St, Harrisburg, IL 62946-2702 | 2011-07-08 |
| 1063708550 | Brent M Jones | Family Medicine | 117 E Clark St, Harrisburg, IL 62946-2702 | 2011-06-22 |
| 1285920835 | Mitchell Andrew Cook | Podiatrist | 117 E Clark St, Harrisburg, IL 62946-2702 | 2011-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770195117 | Leslie Wheeler | Pharmacist | #4 Commercial Drive, Harrisburg, IL 62946 | 2020-08-18 |
| 1215337266 | Prn Pharmacies Ltd | Durable Medical Equipment & Medical Supplies | 501 E. Sloan St., Harrisburg, IL 62946 | 2014-08-27 |
| 1316293855 | Steward Chiropractic Center, LLC | Chiropractor | 608 Rollie Moore Dr., Suite 2, Harrisburg, IL 62946 | 2012-08-02 |
| 1558664664 | Harrisburg Medical Center Inc | Clinic/Center | 183 W Lane St, Equality, IL 62946 | 2010-12-10 |
| 1588849178 | Scarlett Annette Oyler | Technician, Other | 607 W Commercial Suite, Harrisburg, IL 62946 | 2008-01-02 |
| 1043427958 | Debbie Oglesby | Case Manager/Care Coordinator | #22 Veterans Drive, Harrisburg, IL 62946 | 2007-05-17 |
| 1336272764 | Coleman Tri-county Services, Inc. | Community/Behavioral Health | # 22 Veterans Drive, Harrisburg, IL 62946 | 2007-03-14 |
| 1437212081 | Harris Frank LLC | Skilled Nursing Facility | Harrisburg Care Center, 1000 West Sloan St, Harrisburg, IL 62946 | 2006-12-18 |
| 1932269701 | Leanne H Deneal | Physician Assistant | 28 Veteran's Drive, Harrisburg, IL 62946 | 2006-12-11 |
| 1881646990 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 20 Veterans Drive, Harrisburg, IL 62946 | 2006-05-17 |
| Find all providers in zip 62946 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
| 1215944152 | Family Healthcare Clinic & Rehab | Clinic/Center | 701 N Commercial St, Suite 4, Harrisburg, IL 62946-3335 | 2006-08-02 |
| 1578089843 | Harrisburg Medical Center Inc | Clinic/Center | 901 S Commercial St, Harrisburg, IL 62946-2640 | 2017-08-18 |
| 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 |
| 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 |
| 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 | HARRISBURG |
| Zip Code | 62946 |
Please comment or provide details below to improve the information on SOUTHERN ILLINOIS MEDICAL SERVICES, NFP.
| 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.