SIU PHYSICIANS & SURGEONS, INC (NPI# 1871882787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871882787 |
Entity Type | Organization |
Organization Name | SIU PHYSICIANS & SURGEONS, INC |
Other Organization Name | SIU HEALTHCARE |
Practice Address |
315 W Carpenter St Springfield IL 62702-4901 |
Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
Practice Telephone | 2175455817 |
Practice Fax Number | 2175451141 |
Mailing Telephone | 2175457578 |
Mailing Fax Number | 2175451884 |
Enumeration Date | 2011-03-31 |
Last Update Date | 2019-09-05 |
Authorized Official Name | JERRY KRUSE (CEO) |
Authorized Official Telephone | 2175457876 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | ========= | IL | Suppliers |
N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
========= | IL | Suppliers |
Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
SIU HealthCare | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558385989 | Siu Physicians & Surgeons, Inc | Dermatology | 201 E Madison St Ste 300, Springfield, IL 62702-5131 | 2006-07-27 |
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 |
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 |
315 W CARPENTER ST |
City | SPRINGFIELD |
State | IL |
Zip Code | 62702-4901 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457348401 | Jan Rakinic | Colon & Rectal Surgery | 315 W Carpenter St, 2nd Floor, Springfield, IL 62702-4901 | 2005-10-04 |
1124634290 | Amanda C Lee | Nurse Practitioner | 315 W Carpenter St, Springfield, IL 62702-4901 | 2020-09-23 |
1255703971 | Michelle C Gates | Psychologist | 315 W Carpenter St, 1st Floor, Clinic A, Springfield, IL 62702-4901 | 2015-10-21 |
1639561285 | Jessica Dour | Nurse Practitioner | 315 W Carpenter St, 2nd Floor, Clinic C, Springfield, IL 62702-4901 | 2015-02-19 |
1629499769 | Patricia Marie Fank | Psychologist | 315 W Carpenter St, 1st Floor, Springfield, IL 62702-4901 | 2013-12-16 |
1376977371 | Anita D. Schwab | Nurse Practitioner | 315 W Carpenter St, 1st Floor, Springfield, IL 62702-4901 | 2013-08-26 |
1376881136 | Dodie Gazda | Nurse Practitioner | 315 W Carpenter St, Clinic B, Springfield, IL 62702-4901 | 2013-01-29 |
1083962583 | Emily S Lane | Social Worker | 315 W Carpenter St, 3rd Floor, Springfield, IL 62702-4901 | 2012-08-15 |
1265792196 | Kyungsuk Jung | Internal Medicine | 315 W Carpenter St, Clinic B, Springfield, IL 62702 | 2012-05-25 |
1215205109 | Shelda Iverson Borders | Psychologist | 315 W Carpenter St, 3rd Floor, Springfield, IL 62702-4901 | 2011-12-06 |
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 | 207RX0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Medical Oncology |
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295826014 | Thomas Patrick Trezona | Internal Medicine | 3783 International Ct Ste 200, Springfield, OR 97477-1025 | 2006-09-27 |
1356441943 | Osvaldo H Wesly | Internal Medicine | 105 S. Amos Ave, Springfield, IL 62704 | 2006-09-23 |
1346353604 | Murray Bedford PC | Internal Medicine | 222 Carew St Ste 301, Springfield, MA 01104-4103 | 2006-08-17 |
1215923800 | Donald J. Higby | Internal Medicine | 3350 Main Street, Springfield, MA 01199 | 2005-09-20 |
1174173165 | American Oncology Partners, P.a. | Internal Medicine | 3850 S National Ave Ste 600, Springfield, MO 65807-5230 | 2019-09-12 |
1336465715 | Dawn J Brooks | Internal Medicine | 3350 Main Street, Springfield, MA 01107 | 2010-04-11 |
1578701116 | Zaw Min Bo | Internal Medicine | 148 W North St, Springfield, OH 45504-2547 | 2009-02-03 |
1528155967 | Ruth Ann Nevils | Internal Medicine | 3801 S National Ave, Springfield, MO 65807 | 2006-10-06 |
1457445579 | Ernest C Lewis | Internal Medicine | 2115 S Fremont Ave, Suite 1000, Springfield, MO 65804-2239 | 2006-10-03 |
1477659126 | Karen L. Hoelzer | Internal Medicine | 900 N. 1st Street, Springfield, IL 62702-3749 | 2006-09-16 |
Find all providers in SPRINGFIELD |
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.