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SOUTHERN ILLINOIS IMAGING ASSOCIATES LLC NPI 1114019312


NPI Information

NPI: 1114019312
Provider Name: SOUTHERN ILLINOIS IMAGING ASSOCIATES, LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
509 HAMACHER ST
SUITE 300
WATERLOO, IL
ZIP 62298
Phone: (618) 939-9790
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SOUTHERN ILLINOIS IMAGING ASSOCIATES, LLC is a diagnostic radiology radiology in Waterloo, IL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SOUTHERN ILLINOIS IMAGING ASSOCIATES, LLC NPI is 1114019312. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

509 HAMACHER ST
SUITE 300
WATERLOO, IL
ZIP 62298-592
Phone: (618) 939-9790

The provider's authorized official is Michael D. O'brien .
The authorized official title is Authorized Official and has the following contact phone number (513) 281-3400.

The enumeration date for this NPI number is 9/28/2006 and was last updated on 1/28/2008.


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
12085R0202XRadiologyDiagnostic RadiologyYes

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
106732037OTHERILLINOISBC/BS PIN
27829963OTHERAETNA PIN
3P00407886MEDICARE PIN
4215178MEDICARE PINILLINOIS

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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