SOUTHERN ILLINOIS GASTROENTEROLOGY LLC (NPI# 1902467798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902467798 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS GASTROENTEROLOGY LLC |
| Practice Address |
1212 Broadway Highland IL 62249-1960 |
| Practice Telephone | 6183915070 |
| Practice Fax Number | 6182881872 |
| Mailing Telephone | 6183915070 |
| Mailing Fax Number | 6182881872 |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |
| Authorized Official Name | EDMUNDO A RODRIGUEZ-FRIAS (OWNER) |
| Authorized Official Telephone | 6183915070 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Street Address |
1212 BROADWAY |
| City | HIGHLAND |
| State | IL |
| Zip Code | 62249-1960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093785982 | Jennifer Follwell | Family Medicine | 1212 Broadway, Highland, IL 62249-1960 | 2006-01-24 |
| 1851731863 | Lab One LLC | Clinical Medical Laboratory | 1212 Broadway, Suite 1, Highland, IL 62249-1960 | 2013-07-05 |
| 1760636088 | Trisha I. Richards | Physician Assistant | 1212 Broadway, Highland, IL 62249 | 2008-11-13 |
| 1295909570 | Xerex LLC | Legal Medicine | 1212 Broadway, Ste C, Highland, IL 62249-1960 | 2008-04-17 |
| 1225209885 | Excel Care Orthopedics, Inc. | Orthopaedic Surgery | 1212 Broadway, Highland, IL 62249-1960 | 2008-03-21 |
| 1427065580 | Highland Physicians Ltd | Family Medicine | 1212 Broadway, Highland, IL 62249 | 2006-08-02 |
| 1083654594 | Lalit B Choksi | Surgery | 1212 Broadway, Suite B, Highland, IL 62249-1960 | 2006-06-07 |
| 1891734315 | Sara A Mcfarlane | Physician Assistant | 1212 Broadway, Highland, IL 62249 | 2006-06-06 |
| 1972542488 | Roger L Fulton | Internal Medicine | 1212 Broadway, Highland, IL 62249-1960 | 2006-06-06 |
| 1881631604 | Metro East Surgical Specialty Sc | Clinic/Center | 1212 Broadway, Suite B, Highland, IL 62249-1960 | 2006-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750981601 | Michelle Denise Schiefer | Pharmacist | 12495 Il Hwy 143, Highland, IL 62249 | 2020-10-29 |
| 1184235335 | Stephanie Ann Pfeffer | Speech-Language Pathologist | 2813 Il-160, Highland, IL 62249 | 2020-08-12 |
| 1205317898 | Nahant Dialysis LLC | Clinic/Center | 2491 Industrial Dr Ste 200, Highland, IL 62249 | 2018-08-22 |
| 1811432180 | Apollo Medical Holdings | Home Health | 188 Woodcrest Dr, Highland, IL 62249 | 2016-12-22 |
| 1881935781 | Donald Lloyd Chaney | Family Medicine | 3833 Meadow Lane, Highland, IL 62249 | 2013-03-04 |
| 1871842112 | Dental Professionals of Illinois, P.C. | Dentist | 12605 Troxler Ave, Highland, IL 62249 | 2012-08-31 |
| 1770866428 | 3f Vision LLC | Optometrist | Unit # 1 12603 Il Highway 143, Highland, IL 62249 | 2011-09-20 |
| 1396075305 | Theresa E Howard | Counselor | 3636 Villa Park Drive, Highland, IL 62249 | 2010-01-14 |
| 1710127295 | Eric Bernard Kosel | Dentist | 380 Suppiger Way #3, Highland, IL 62249 | 2009-02-24 |
| 1528206745 | Holley Anne Friesz Heidel | Speech-Language Pathologist | 13 Triland Court, Highland, IL 62249 | 2009-01-26 |
| Find all providers in zip 62249 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1316203367 | Mohsen R Khan | Internal Medicine | 9731 Prairie Ave, Highland, IN 46322-3616 | 2012-04-04 |
| 1538396411 | Christopher Michael Flannery | Internal Medicine | 7000 Boulder Ave, Highland, CA 92346-3348 | 2009-06-17 |
| 1659470110 | John L Kniaz | Internal Medicine | 9731 Prairie Ave, Highland, IN 46322-3616 | 2006-09-21 |
| 1295774966 | Richard M. Strong | Internal Medicine | 7000 Boulder Ave, Highland, CA 92346-3348 | 2006-06-06 |
| 1982642724 | Mark Gabriel | Internal Medicine | 7000 Boulder Ave, Highland, CA 92346-3348 | 2006-06-03 |
| 1942256581 | Lida Zhen | Internal Medicine | 7000 Boulder Ave, Highland, CA 92346-3348 | 2006-05-25 |
| 1942250030 | Peter S. Kim | Internal Medicine | 821 Poplar St, Highland, IL 62249-1658 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013487388 | Endoscopy Center of The North Shore, LLC | Internal Medicine | 1100 Central Ave Ste H, Wilmette, IL 60091-2666 | 2018-11-29 |
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1861999559 | Kiba, Inc. | Internal Medicine | 3845 Mccoy Dr Ste 101, Aurora, IL 60504-4429 | 2018-04-09 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1699186890 | Laura Hamad | Internal Medicine | 1717 Midwest Club Pkwy, Oak Brook, IL 60523-2586 | 2014-05-11 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1841533254 | Danish Shahab | Internal Medicine | 133 E Brush Hill Rd Ste 100&400, Elmhurst, IL 60126-5659 | 2013-04-03 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
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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.