SOUTHERN ILLINOIS NEUROLOGIC INSTITUTE NPI 1629190657

NPI Information

SOUTHERN ILLINOIS NEUROLOGIC INSTITUTE is a specialist in Belleville, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHERN ILLINOIS NEUROLOGIC INSTITUTE NPI is 1629190657. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 N JACKSON ST
BELLEVILLE, IL
ZIP 62220-427
Phone: (618) 239-6660
Fax: (618) 239-6662

The provider's authorized official is Guy Timothy Burrows .
The authorized official title is Owner and has the following contact phone number (618) 239-6660.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 7/2/2008.

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:

Other Identifiers

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