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SOUTHERN ILLINOIS PHYSICIAN SERVICES PC NPI 1508953746


NPI Information

NPI: 1508953746
Provider Name: SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
4600 MEMORIAL DRIVE
SUITE 340
BELLEVILLE, IL
ZIP 62226
Phone: (618) 222-9999
Get Directions

SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC 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 PHYSICIAN SERVICES, PC NPI is 1508953746. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4600 MEMORIAL DRIVE
SUITE 340
BELLEVILLE, IL
ZIP 62226
Phone: (618) 222-9999
Fax: (618) 222-9337

The provider's authorized official is Rebecca J Tiberend .
The authorized official title is Billing Officer Supervisor and has the following contact phone number (618) 222-9999.

The enumeration date for this NPI number is 10/9/2006 and was last updated on 6/21/2018.


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
1207VG0400XObstetrics & GynecologyGynecologyNo
22084P0800XPsychiatry & NeurologyPsychiatryNo
3208800000XUrologyNo
4207RG0100XInternal MedicineGastroenterologyYes

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
1=========OTHERILLINOISGROUP FEIN #

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.