SOUTHERN ILLINOIS MEDICAL SERVICES NFP NPI 1538689062

NPI Information

NPI: 1538689062
Provider Name: SOUTHERN ILLINOIS MEDICAL SERVICES, NFP

Doing Business As: SIH MEDICAL GROUP ANNA PRIMARY CARE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
98 PEACH RIDGE RD
ANNA, IL
ZIP 62906
Phone: (618) 614-1400
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SOUTHERN ILLINOIS MEDICAL SERVICES, NFP is a rural health clinic center in Anna, IL. SOUTHERN ILLINOIS MEDICAL SERVICES, NFP NPI is 1538689062. The provider is registered as an organization entity type.
The provider Is Doing Business As Sih Medical Group Anna Primary Care.

The provider's business location address is:

98 PEACH RIDGE RD
ANNA, IL
ZIP 62906-243
Phone: (618) 614-1400
Fax: (618) 614-1401

The provider's authorized official is Kimberly Sue Lingle .
The authorized official title is Director Finance and has the following contact phone number (618) 457-5200.

The CLIA number assigned to this NPI record is 14D2132982 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2017 and was last updated on 7/21/2022.

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
1	261QR1300X	Clinic/Center	Rural Health		ILLINOIS	Yes

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
1	1770656837	MEDICAID	ILLINOIS

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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