SOUTHERN ILLINOIS PAIN MANAGEMENT (NPI# 1942227863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942227863 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS PAIN MANAGEMENT |
| Practice Address |
3905 W Ernestine Dr Marion IL 62959-5800 |
| Practice Telephone | 6189935859 |
| Practice Fax Number | 6189971588 |
| Mailing Telephone | 6189935859 |
| Mailing Fax Number | 6189971588 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2011-01-18 |
| Authorized Official Name | MR. PAUL BRIAN JUERGENS (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 6189935859 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
3905 W ERNESTINE DR |
| City | MARION |
| State | IL |
| Zip Code | 62959-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801211784 | Emily Sumner | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2014-02-28 |
| 1881947612 | Brynn Erin Basinger | Speech-Language Pathologist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2012-10-17 |
| 1679861710 | Daniel Lee Porter | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2011-07-11 |
| 1538314414 | Performance Chiropractic of Southern Illinois LLC | Chiropractor | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-11-19 |
| 1144478330 | Heartland Spine, LLC | Neurological Surgery | 3905 W Ernestine Dr, Marion, IL 62959-5800 | 2008-09-03 |
| 1154506228 | Julie T Tiu | Physical Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-01-08 |
| 1689859944 | Sarah Renee Surprenant | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-01-07 |
| 1972788305 | David A Martin | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-01-03 |
| 1295933315 | Robert J Marsh | Psychologist | 3905 W Ernestine Dr, Marion, IL 62959-5800 | 2007-07-10 |
| 1659439081 | Ryan August Gullett | Chiropractor | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740828367 | Kimberly J Lewis | Specialist | 3832 Cory Corners Rd, Marion, NY 14505-9722 | 2019-12-13 |
| 1861829814 | Michael E Steuer, Md, PC | Specialist | 2860 Interstate 55, Ste 7, Marion, AR 72364-2111 | 2013-10-07 |
| 1922376565 | Shannon Lynn White | Specialist | 2513 W 2nd St, Marion, IN 46952-3241 | 2011-12-11 |
| 1689996332 | Southmountain Children and Family Services | Specialist | 81 W Fort St, Marion, NC 28752 | 2010-02-23 |
| 1376743070 | Mcdowell Orthopaedics & Sports Medicine, P.a. | Specialist | 60 S Medical Ct, Marion, NC 28752-4972 | 2007-07-20 |
| 1376759282 | Normal Life of Indiana | Specialist | 201 N Baldwin Ave, Marion, IN 46952-3533 | 2007-05-15 |
| 1285847459 | Marion Pediatric Clinic | Specialist | 31 E Medical Ct Ste 1, Marion, NC 28752-4969 | 2007-05-07 |
| 1720208762 | Elsie Brown | Specialist | 801 W Boulevard St, Marion, IL 62959-1737 | 2007-05-01 |
| 1174684138 | Marion Surgeons, Inc | Specialist | 1395 N Baldwin Ave, Marion, IN 46952-1913 | 2006-12-13 |
| 1467559153 | Charles William Mc Rae | Specialist | 302 Oliver St, Marion, SC 29571-2338 | 2006-09-17 |
| Find all providers in MARION | ||||
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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.