PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS NPI 1740421536

NPI Information

  • NPI: 1740421536
  • Provider Name: PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Doing Business As: ST MARYS GOOD SAMARITAN MEDICAL GROUP
  • Address: 430 N PLEASANT AVE
    CENTRALIA, IL
    ZIP 62801
  • Phone: (618) 532-9350

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NPI Details

PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS is an obstetrics gynecology in Centralia, IL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS NPI is 1740421536. The provider is registered as an organization entity type.
The provider Is Doing Business As St Marys Good Samaritan Medical Group.

The provider's business location address is:

430 N PLEASANT AVE
CENTRALIA, IL
ZIP 62801-006
Phone: (618) 532-9350

The provider's authorized official is Tammy Simonton .
The authorized official title is Mng and has the following contact phone number (618) 436-6267.

The enumeration date for this NPI number is 3/9/2009 and was last updated on 3/12/2009.

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
1261QR1300XClinic/CenterRural Health002642ILLINOISNo
2207V00000XObstetrics & Gynecology036116791ILLINOISYes

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
11831101807OTHERILLINOISCMS GRP NPI
2148999MEDICARE OSCAR/CERTIFICATIONILLINOIS

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: 3/30/2025

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