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GASTROENTEROLOGY CARE OF SOUTHERN ILLINOIS LLC NPI 1609914183


NPI Information

NPI: 1609914183
Provider Name: GASTROENTEROLOGY CARE OF SOUTHERN ILLINOIS, LLC

Doing Business As: SUSHILKUMAR TIBREWALA, MD

Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
3301 PATRIOT CT
HERRIN, IL
ZIP 62948
Phone: (618) 998-8885
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GASTROENTEROLOGY CARE OF SOUTHERN ILLINOIS, LLC is a gastroenterology internal medicine in Herrin, IL. The provider is 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. GASTROENTEROLOGY CARE OF SOUTHERN ILLINOIS, LLC NPI is 1609914183. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Sushilkumar Tibrewala, Md.

The provider's business location address is:

3301 PATRIOT CT
HERRIN, IL
ZIP 62948-782
Phone: (618) 998-8885
Fax: (618) 998-8886

The provider's authorized official is Sushilkunar Mahabirprasad Tibrewala .
The authorized official title is President and has the following contact phone number (618) 998-8885.

The enumeration date for this NPI number is 2/4/2007 and was last updated on 9/11/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0100XInternal MedicineGastroenterology036-073571ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1046565OTHERILLINOISHEALTH ALLIANCE
20010023397OTHERILLINOISBCBS OF IL
3833199720OTHERILLINOISAETNA
4173109OTHERILLINOISHEALTHLINK PPO
5036073571MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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