DR. SONGYOTH SAKDISRI (NPI# 1932202744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932202744 |
| Entity Type | Individual |
| Full Name | DR. SONGYOTH SAKDISRI |
| Credential | MD |
| Practice Address |
2001 State St East Saint Louis IL 62205-1803 |
| Practice Telephone | 6182719191 |
| Practice Fax Number | 6182719617 |
| Mailing Telephone | 6182719191 |
| Mailing Fax Number | 6182719617 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2011-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 036148571 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036048571 | 05 |
| Street Address |
2001 STATE ST |
| City | EAST SAINT LOUIS |
| State | IL |
| Zip Code | 62205-1803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740247360 | Dolores J Gunn | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2006-04-27 |
| 1184845257 | Rina S. Patney | Pediatrics | 2001 State St, East Saint Louis, IL 62205-1803 | 2007-05-02 |
| 1811054935 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2007-01-02 |
| 1245396886 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2006-12-28 |
| 1265527998 | Miguel H. Granger | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2006-10-04 |
| 1144322264 | Joyce A Mckinney | Registered Nurse | 2001 State St, East Saint Louis, IL 62205-1803 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790156610 | Lessie Bates Davis Neighborhood House | Registered Nurse | 1200 North 13th Street, East Saint Louis, IL 62205 | 2015-10-19 |
| 1114047859 | Herschel Lee Garrett Jr. | Dentist | 4020 Caseyville Ave, East St Louis, IL 62205 | 2007-03-29 |
| 1376871103 | Toni M. Jackson | Massage Therapist | 4806 State St, Home Office, East Saint Louis, IL 62205-1355 | 2009-12-07 |
| 1811347362 | Destinee Hope Grove | Specialist/Technologist | 4901 State St, East Saint Louis, IL 62205-1356 | 2016-06-15 |
| 1053963470 | Stephanie Michelle Tate-patterson | Nurse Practitioner | 4901 State St, East Saint Louis, IL 62205-1356 | 2019-07-16 |
| 1710406962 | Christa R Dyson-spiller | Nurse Practitioner | 4901 State St, East Saint Louis, IL 62205-1356 | 2017-09-19 |
| 1558344986 | Gerard X Blaise | Dentist | 4601 State St, Ste 300, East Saint Louis, IL 62205-1359 | 2005-11-21 |
| 1013269737 | Illinois Express Home Care | In Home Supportive Care | 4601 State St, East Saint Louis, IL 62205-1359 | 2012-10-04 |
| 1427227891 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 4601 State St, East Saint Louis, IL 62205-1359 | 2008-02-29 |
| 1801065289 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 4601 State St, East Saint Louis, IL 62205-1359 | 2008-02-29 |
| Find all providers in zip 62205 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700972833 | Darrell M. Ballinger | Obstetrics & Gynecology | 6000 Bond Ave, East Saint Louis, IL 62207-2328 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162210 | Clair L Casagrande | Obstetrics & Gynecology | 1300 Franklin Ave Ste 330, Normal, IL 61761-4204 | 2020-10-23 |
| 1699382531 | Contemporary Ob/gyn Chicago, Pllc | Obstetrics & Gynecology | 2007 S State St, Chicago, IL 60616-2173 | 2020-09-24 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1851910210 | Wayne Richard Burrows | Obstetrics & Gynecology | 1412 S Diamond St, South Jacksonville, IL 62650-3143 | 2020-04-15 |
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1962050971 | Jessica Erin Buesing | Obstetrics & Gynecology | 27790 W Highway 22 Ste 37, Barrington, IL 60010-2396 | 2019-09-03 |
| 1235784760 | Gynecologic Surgery & Menopause Solutions PC | Obstetrics & Gynecology | 1890 Silver Cross Blvd Ste 445, New Lenox, IL 60451-9622 | 2019-08-01 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1164980769 | Hanna Legator | Obstetrics & Gynecology | 1875 Dempster St Ste 300, Park Ridge, IL 60068-1186 | 2019-03-04 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| Find all providers with the same taxonomy | ||||
| City | EAST SAINT LOUIS |
| Zip Code | 62205 |
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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.