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SOUTHERN ILLINOIS ENDOSCOPY NPI 1083988380


NPI Information

NPI: 1083988380
Provider Name: SOUTHERN ILLINOIS ENDOSCOPY
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
2810 FRANK SCOTT PARKWAY
SUITE 716
BELLEVILLE, IL
ZIP 62223
Phone: (618) 355-0880
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SOUTHERN ILLINOIS ENDOSCOPY is a gastroenterology internal medicine in Belleville, 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. SOUTHERN ILLINOIS ENDOSCOPY NPI is 1083988380. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2810 FRANK SCOTT PARKWAY
SUITE 716
BELLEVILLE, IL
ZIP 62223-802
Phone: (618) 355-0880
Fax: (618) 355-0881

The provider's authorized official is Vasantha Perje Pai .
The authorized official title is President and has the following contact phone number (618) 355-0880.

The enumeration date for this NPI number is 3/5/2012 and was last updated on 3/5/2012.


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 MedicineGastroenterology036.097852ILLINOISYes

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
1G48287MEDICARE UPIN

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: 11/14/2023

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