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SOUTHERN ILLINOIS GI SPECIALISTS LLC NPI 1093775405


NPI Information

NPI: 1093775405
Provider Name: SOUTHERN ILLINOIS GI SPECIALISTS LLC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 14D2074735

Address:
1100 W DIANN LN
CARBONDALE, IL
ZIP 62901
Phone: (618) 549-8006
Get Directions

SOUTHERN ILLINOIS GI SPECIALISTS LLC is a gastroenterology internal medicine in Carbondale, 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 GI SPECIALISTS LLC NPI is 1093775405. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1100 W DIANN LN
CARBONDALE, IL
ZIP 62901-339
Phone: (618) 549-8006
Fax: (618) 549-8434

The provider's authorized official is Zahoor A Makhdoom .
The authorized official title is Md Owner and has the following contact phone number (618) 549-8006.

The CLIA number assigned to this NPI record is 14D2074735 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/28/2006 and was last updated on 8/12/2008.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterology036094155ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036094155MEDICAIDILLINOIS
2210478MEDICARE PINILLINOIS
303926864OTHERILLINOISBCBS IL
4063398OTHERHEALTH ALLIANCE HMO
5435384OTHERHEALTHLINK
6G55154MEDICARE UPIN
7DG1904MEDICARE PIN

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: 5/5/2024

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