PHYSICIANS SURGERY CENTER, LLC (NPI# 1023297553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023297553 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS SURGERY CENTER, LLC |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Practice Telephone | 6185495361 |
| Mailing Telephone | 6185495361 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | DR. SHEFFIELD BOARDMAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6185495361 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTH LINK | 878466 | 01 | |
| HEALTH ALLIANCE | 014101 | 01 | |
| GROUP HEALTH PLANS | 328614 | 01 | |
| IL | BLUE CROSS OF ILLINOIS | 50935 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356395586 | Physicians Surgery Center, LLC | Clinic/Center | 1485 E 3900 S, Salt Lake City, UT 84124-1412 | 2006-05-20 |
| 1194729590 | Physicians Surgery Center, LLC | Clinic/Center | 1 Mercado St, Suite 210, Durango, CO 81301 | 2005-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | PHYSICIANS SURGERY CENTER, LLC | 9100 E. Mineral Circle, Centennial, CO 80112 |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1184196883 | Leslie Ann Hickman | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-12-19 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699052621 | Physicians Surgery Center Anesthesia | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2011-11-04 |
| 1679639918 | The Carbondale Clinic Ambulatory Surgical Treatment Center | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2006-12-29 |
| 1407921786 | Marian Community Hospital | Clinic/Center | 100 Lincoln Ave, Carbondale, PA 18407-2116 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184245375 | Specialty Surgicare, Ltd | Clinic/Center | 500 W Golf Rd Ste 102, Schaumburg, IL 60195-3503 | 2020-04-29 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1619519535 | Anderson Surgery Center LLC | Clinic/Center | 3403 Anderson Healthcare Drive, Edwardsville, IL 62025 | 2019-10-11 |
| 1922664622 | Premier Cardiac Surgery Center, LLC | Clinic/Center | 11560 S Kedzie Ave Ste 102, Merrionette Park, IL 60803-4517 | 2019-05-17 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1477017333 | Ontario Street Operatory | Clinic/Center | 22 W Ontario St, Chicago, IL 60654-5169 | 2019-01-24 |
| 1407329501 | Chicago Cosmetic Surgery Institute | Clinic/Center | 2335 S Michigan Ave, Chicago, IL 60616-2104 | 2019-01-10 |
| 1538647474 | Palos Health Surgery Center, LLC | Clinic/Center | 15300 West Ave Ste 260, Orland Park, IL 60462-4600 | 2018-08-02 |
| 1013493824 | Ann & Robert H. Lurie Children's Hospital of Chicago | Clinic/Center | 1121 Techny Rd, Northbrook, IL 60062-5503 | 2018-07-15 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.