SOUTHERN OBSTETRIC & GYNECO ASSOCIATES (NPI# 1962793687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962793687 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OBSTETRIC & GYNECO ASSOCIATES |
| Other Organization Name | SOUTHERN OB/GYN-HIGHLAND |
| Practice Address |
1328 Mercantile Dr Highland IL 62249-1257 |
| Mailing Address |
9447 Holy Cross Ln Breese IL 62230-3510 |
| Practice Telephone | 6186544836 |
| Practice Fax Number | 6185267372 |
| Mailing Telephone | 6185262209 |
| Mailing Fax Number | 6185267372 |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |
| Authorized Official Name | ANNE DOLL-POLLARD (PRESIDENT) |
| Authorized Official Telephone | 6185262209 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 042005236 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CORPORATE LICENSE | 042005236 | 01 |
| Other Name | Type Code |
|---|---|
| Southern OB/GYN-Highland | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467419804 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2006-04-28 |
| 1134484249 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 211 E Hanover St, New Baden, IL 62265-1811 | 2012-07-05 |
| 1881958981 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 1201 Ricker Rd, Salem, IL 62881-4263 | 2012-07-03 |
| 1174887277 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2012-07-03 |
| 1205199452 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 700 S Dewey St, Greenville, IL 62246-2288 | 2012-06-22 |
| Street Address |
1328 MERCANTILE DR |
| City | HIGHLAND |
| State | IL |
| Zip Code | 62249-1257 |
| 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 | 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 |
|---|---|---|---|---|
| 1881658789 | Woman's Complete Health Care Center, P.C. | Obstetrics & Gynecology | 3641 Ridge Rd, Highland, IN 46322-2080 | 2006-04-17 |
| 1508827072 | Kari F. Lawrence | Obstetrics & Gynecology | 10968 N Alpine Hwy, Highland, UT 84003-8874 | 2006-03-31 |
| 1700858958 | Molly Cowgill | Obstetrics & Gynecology | 652 Route 299, Ste 102, Highland, NY 12528 | 2006-02-02 |
| 1790785046 | Nadine Stacy-marie Lyseight | Obstetrics & Gynecology | 4240 Highland Ave, Highland, CA 92346-2764 | 2005-07-28 |
| 1659791788 | Osama Adnan Zaghmout | Obstetrics & Gynecology | 3100 45th St, Highland, IN 46322 | 2014-04-16 |
| 1093133563 | Health Quest Medical Practice | Obstetrics & Gynecology | 514 Route 299, Highland, NY 12528-2835 | 2014-04-02 |
| 1013356336 | Peter Ehren Sterbutzel | Obstetrics & Gynecology | 4240 Highland Ave, Highland, CA 92346-2764 | 2013-06-19 |
| 1083958698 | Upland Hills Health, Inc. | Obstetrics & Gynecology | 551 Main St, Highland, WI 53543-9779 | 2012-11-20 |
| 1093806382 | Shellee Rae Lazar | Obstetrics & Gynecology | 4240 Highland Ave, Suite B, Highland, CA 92346-2764 | 2006-09-28 |
| 1710922141 | Brian Beitel | Obstetrics & Gynecology | 7000 Boulder Ave, Highland, CA 92346-3348 | 2006-06-19 |
| Find all providers in HIGHLAND | ||||
Please comment or provide details below to improve the information on SOUTHERN OBSTETRIC & GYNECO ASSOCIATES.
| 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.