SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE (NPI# 1851731640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851731640 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE |
| Practice Address |
701 N 1st St Room D443 Springfield IL 62702-3757 |
| Mailing Address |
701 North First Street Springfield IL 62712 |
| Practice Telephone | 2175450193 |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |
| Authorized Official Name | ANDREW VERNEY (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 2175450193 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 284300000X | Special Hospital | 125063931 | IL | Hospitals |
| Street Address |
701 N 1ST ST ROOM D443 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607123 | Memorial Home Services | Home Health | 701 N 1st St, Springfield, IL 62781-4952 | 2005-05-23 |
| 1316552524 | Mary Ann Seagle | Nurse Practitioner | 701 N 1st St, Springfield, IL 62781-0001 | 2020-09-14 |
| 1497372361 | Amir Mcphearson | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-26 |
| 1508482597 | Kirsten Kay Carew | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-25 |
| 1699391482 | Aruya Davis | Registered Nurse | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-17 |
| 1497370852 | Alyssa Rose Jimerson | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-11 |
| 1649895038 | Elisha Boyd | Nurse Practitioner | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-10 |
| 1275158990 | Ashley L Mcgrath | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-09 |
| 1205451812 | Christopher Evan Bejcek | Orthopaedic Surgery | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-09 |
| 1912521790 | Neil Carter Parker | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-08 |
| Find all providers in the same location | ||||
| 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 | 284300000X |
| Grouping | Hospitals |
| Classification | Special Hospital |
| A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |
| Notes: Source: AHA Guide, Registration section, p. A5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710231931 | Veterans Health Care System of The Ozarks | Special Hospital | 6308 S Hunters Trl, Springfield, MO 65810-1968 | 2012-11-09 |
| 1619232451 | Mercy Anesthesia, Inc | Special Hospital | 100 W Main St, Springfield, OH 45502-1312 | 2012-07-09 |
| 1518150499 | Us Medical Center for Federal Prisoners | Special Hospital | 1900 W Sunshine St, Springfield, MO 65807-2240 | 2007-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679939417 | Kyuhun Park | Special Hospital | 2540 N Harlem Ave, Elmwood Park, IL 60707-2046 | 2016-01-09 |
| 1902210164 | Alexis De Gale | Special Hospital | 1050 Bonaventure Dr, Elk Grove Village, IL 60007-3277 | 2014-06-16 |
| 1417369976 | Arthur Berg | Special Hospital | 14 Bradford Ln, Oak Brook, IL 60523-2322 | 2014-06-02 |
| 1063823557 | Beaumont Small Animal Clinic | Special Hospital | 1304 N Cunningham Ave, Urbana, IL 61802-1817 | 2014-05-19 |
| 1932407772 | Kevin Wayne Ames | Special Hospital | 2005 Mall St, Collinsville, IL 62234-1832 | 2011-03-02 |
| 1366645590 | Jeremy Peter Buishas | Special Hospital | 21 S. Park Blvd, Glen Ellyn, IL 60137 | 2007-06-06 |
| 1508073347 | Ciwirc ( Central Illinois Work Injury Resource Center ) | Special Hospital | 736 Sw Washington St Ste 2a, Peoria, IL 61602-1643 | 2007-05-17 |
| 1396083796 | County Line Animal Hospita | Special Hospital | 2200 S Washington St, Naperville, IL 60565-2495 | 2013-01-21 |
| 1184998627 | Patrice Kathleen Griffin | Special Hospital | 2525 S Michigan Ave, B-522, Chicago, IL 60616-2333 | 2012-03-01 |
| 1275812182 | Mercy Hospital Medical Centre | Special Hospital | 2525 S Michigan Ave, Mercy Hospital Medical Center, Chicago, IL 60616-2333 | 2011-08-09 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.