Socorro Justiniani Shelton (NPI# 1780905638, PAC ID# 2860526639) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1780905638 |
| PAC ID by PECOS | 2860526639 |
| Professional Enrollment ID | I20100816000414 |
| Full Name | Socorro Justiniani Shelton |
| Organization Legal Name | SIU PHYSICIANS AND SURGEONS INC |
| Address |
305 W Jackson St Suite 200 Carbondale IL 62901-1474 |
| Phone Number | 6184533777 |
| Gender | F |
| Graduation Year | 2007 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 2365352820 |
| Number of Group Practice Members | 236 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140164 | MEMORIAL HOSPITAL OF CARBONDALE |
| 140011 | SOUTHERN ILLINOIS HOSPITAL SERVICES DBA HERRIN HOSPITAL |
| 141334 | ST JOSEPH MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 6184533777 | SIU PHYSICIANS AND SURGEONS INC |
| 2553 Ken Gray Blvd, W Frankfort, IL 62896-4174 | 6189322155 | SOUTHERN ILLINOIS HOSPITAL SERVICES |
| Organization Legal Name | SIU PHYSICIANS AND SURGEONS INC |
| Physicians | 259 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda M Clouser | Nurse Practitioner | Siu Physicians and Surgeons Inc | 315 W Carpenter St, Springfield, IL 62702-4901 |
| Kristina Epplin Sondgeroth | Obstetrics/gynecology | Siu Physicians and Surgeons Inc | 400 N 9th St, 3rd Floor Clinic B, Springfield, IL 62702-5310 |
| Evans M Mutua | Nurse Practitioner | Siu Physicians and Surgeons Inc | 720 N Bond St, Springfield, IL 62702-4952 |
| Lori A Bland | Nurse Practitioner | Siu Physicians and Surgeons Inc | 102 W Kenwood Ave, Lowr Level, Decatur, IL 62526-4368 |
| Carmen A Orellana Martinez | Psychiatry | Siu Physicians and Surgeons Inc | 319 E Madison St, Fl 3, Springfield, IL 62701-1035 |
| Basar Cenik | Psychiatry | Siu Physicians and Surgeons Inc | 901 W Jefferson St, Springfield, IL 62702-4833 |
| Henry Olugbenga Adekola | Obstetrics/gynecology | Siu Physicians and Surgeons Inc | 415 N 9th St, Springfield, IL 62702-5303 |
| Momin Saulat Siddique | Cardiovascular Disease (cardiology) | Siu Physicians and Surgeons Inc | 340 W Miller St, Springfield, IL 62702-4928 |
| Kaylie A Caswell | Nurse Practitioner | Siu Physicians and Surgeons Inc | 1100 E Lincolnshire Blvd, Suite 200, Springfield, IL 62703-5950 |
| Lorie Ann Sporrer | Nurse Practitioner | Siu Physicians and Surgeons Inc | 301 N 8th St, Springfield, IL 62701-1041 |
| Street Address |
305 W JACKSON ST SUITE 200 |
| City | CARBONDALE |
| State | IL |
| Zip | 62901-1474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Esteban Eduardo Golombievski | Neurology | Southern Illinois Medical Services, Nfp | 305 W Jackson St, Suite 103, Carbondale, IL 62901-1474 |
| Antonio Lozada | General Surgery | Southern Illinois Medical Services, Nfp | 305 W Jackson St, Suite 302, Carbondale, IL 62901-1474 |
| Scott Kenneth Schonewolf | Family Medicine | Siu Physicians and Surgeons Inc | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 |
| Alejandro Hornik | Neurology | Southern Illinois Medical Services, Nfp | 305 W Jackson St, Suite 103, Carbondale, IL 62901-1474 |
| Kyaw Thet Naing | Family Medicine | Siu Physicians and Surgeons Inc | 305 W Jackson St, Suite 106, Carbondale, IL 62901-1474 |
| Dana A Oberg | Nurse Practitioner | Southern Illinois Ob-gyn Associates Sc | 305 W Jackson St, Suite 402, Carbondale, IL 62901-1474 |
| Ashley Nicole Freeman | Nurse Practitioner | Southern Illinois Medical Services, Nfp | 305 W Jackson St, Suite 103, Carbondale, IL 62901-1474 |
| Kulsoom Laeeq | General Surgery | Southern Illinois Medical Services, Nfp | 305 W Jackson St, Suite 302, Carbondale, IL 62901-1474 |
| Andrea M Humphrey | Family Medicine | New Horizons Obstetrics and Gynecology | 305 W Jackson St, Suite 100, Carbondale, IL 62901-1474 |
| Gerson A Criste | Pain Management | Southern Illinois Medical Services, Nfp | 305 W Jackson St, Suite 103, Carbondale, IL 62901-1474 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy Nichole Dinga | Nurse Practitioner | Southern Illinois Medical Services, Nfp | 1400 Financial Park Dr, Carbondale, IL 62901 |
| Carlos Mario Rivera Serrano | Plastic and Reconstructive Surgery | Southern Illinois Medical Services, Nfp | 1400 Financial Park Dr, Carbondale, IL 62901 |
| Kelli Nicole Webb | Plastic and Reconstructive Surgery | Southern Illinois Medical Services, Nfp | 1400 Financial Park Dr, Carbondale, IL 62901 |
| Fakhre Alam | Neurology | 2731 W Main St, Suite A, Carbondale, IL 62901-1028 | |
| Muhammad J Popalzai | Hematology/oncology | Southern Illinois Medical Services, Nfp | 2601 W Main St, Carbondale, IL 62901-1031 |
| Melissa Andrea Martinez Mateo | Gastroenterology | Southern Illinois Medical Services, Nfp | 2601 W Main St, Carbondale, IL 62901-1031 |
| Lukas John Ward | Physician Assistant | Southern Illinois Medical Services, Nfp | 2601 W Main St, Carbondale, IL 62901-1031 |
| Emily D Hanson | Family Medicine | Southern Illinois Medical Services, Nfp | 2601 W Main St, Carbondale, IL 62901-1031 |
| Phillip A Dewey | Physician Assistant | Southern Illinois Medical Services, Nfp | 2601 W Main St, Carbondale, IL 62901-1031 |
| Jessie Nicole Fox | Nurse Practitioner | Southern Illinois Medical Services, Nfp | 2601 W Main St, Carbondale, IL 62901-1031 |
| Find all physicians in zip 62901 | |||
| City | CARBONDALE |
| Zip Code | 62901 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CARBONDALE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Socorro Justiniani Shelton.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.