SIU PHYSICIANS & SURGEONS, INC (NPI# 1093739435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093739435 |
| Entity Type | Organization |
| Organization Name | SIU PHYSICIANS & SURGEONS, INC |
| Practice Address |
701 N 1st St D235 Springfield IL 62781-0001 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2175457578 |
| Practice Fax Number | 2175451884 |
| Mailing Telephone | 2175457578 |
| Mailing Fax Number | 2175451884 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | DAVID TKACH (CEO) |
| Authorized Official Telephone | 2175457578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | ========= | IL | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
========= | IL | Allopathic & Osteopathic Physicians |
| N | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
========= | IL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | ========= | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | CE8688 | 01 |
| IL | RR MEDICARE | CE8686 | 01 |
| IL | RR MEDICARE | CE8931 | 01 |
| IL | RR MEDICARE | CB2589 | 01 |
| IL | RR MEDICARE | CE8687 | 01 |
| IL | RR MEDICARE | CE8689 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558385989 | Siu Physicians & Surgeons, Inc | Dermatology | 201 E Madison St Ste 300, Springfield, IL 62702-5131 | 2006-07-27 |
| 1790705507 | Siu Physicians & Surgeons, Inc | Orthopaedic Surgery | 720 N Bond St, Springfield, IL 62702-4952 | 2006-07-21 |
| 1164055976 | Siu Physicians & Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 747 N Rutledge St Fl 5, Springfield, IL 62702-6700 | 2020-02-20 |
| 1942849096 | Siu Physicians & Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 720 N Bond St, Springfield, IL 62702-4952 | 2020-01-06 |
| 1396211975 | Siu Physicians & Surgeons, Inc | Case Management | 201 E Madison St Ste 300, Springfield, IL 62702-5131 | 2018-10-22 |
| 1053804443 | Siu Physicians & Surgeons, Inc | Clinic/Center | 610 N Westgate Ave, Jacksonville, IL 62650-1152 | 2018-06-11 |
| 1457807869 | Siu Physicians & Surgeons, Inc | Clinic/Center | 608 S Main St, Anna, IL 62906-1247 | 2016-08-27 |
| 1871882787 | Siu Physicians & Surgeons, Inc | Internal Medicine | 315 W Carpenter St, Springfield, IL 62702-4901 | 2011-03-31 |
| 1821290057 | Siu Physicians & Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 747 N Rutledge St, 3rd Floor, Springfield, IL 62702-6700 | 2007-06-01 |
| 1467476895 | Siu Physicians & Surgeons, Inc | Counselor | 701 N 1st St, D235, Springfield, IL 62781-0001 | 2006-07-27 |
| Street Address |
701 N 1ST ST D235 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62781-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607123 | Memorial Home Services | Home Health | 701 N 1st St, Springfield, IL 62781-4952 | 2005-05-23 |
| 1316552524 | Mary Ann Seagle | Nurse Practitioner | 701 N 1st St, Springfield, IL 62781-0001 | 2020-09-14 |
| 1497372361 | Amir Mcphearson | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-26 |
| 1508482597 | Kirsten Kay Carew | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-25 |
| 1699391482 | Aruya Davis | Registered Nurse | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-17 |
| 1497370852 | Alyssa Rose Jimerson | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-11 |
| 1649895038 | Elisha Boyd | Nurse Practitioner | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-10 |
| 1275158990 | Ashley L Mcgrath | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-09 |
| 1205451812 | Christopher Evan Bejcek | Orthopaedic Surgery | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-09 |
| 1912521790 | Neil Carter Parker | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104145747 | Justin Neil Henry | Hospitalist | 701 N 1st St Rm B146, Springfield, IL 62781 | 2010-05-21 |
| 1457464208 | Edward J Ryan Poje | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| 1649285453 | Sanjai Nagendra | Pathology | 701 N First Street, Springfield, IL 62781 | 2006-07-30 |
| 1770518706 | Daniel L Stanton Jr. | Radiology | 701 N. First St, Springfield, IL 62781 | 2006-07-11 |
| 1497914741 | Ted Robert Clark | Emergency Medicine | 701 N. 1st Street, Springfield, IL 62781 | 2008-06-03 |
| 1851486393 | Joan Lewis | Nurse Practitioner | 701 N First St, Springfield, IL 62781 | 2006-10-03 |
| 1548363138 | Pathology Associates of Central Illinois Ltd | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-09-07 |
| 1962511931 | Chad Joseph Defrain | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1346359320 | Nassim Banisaeed | Pathology | 701 N First St, Memorial Medical Center, Springfield, IL 62781 | 2006-08-30 |
| 1922111772 | John E Murphy | Pathology | 701 N First Street, Memorial Medical Center, Springfield, IL 62781 | 2006-08-16 |
| Find all providers in zip 62781 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62781 |
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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.