PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS S.C (NPI# 1316271653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316271653 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS S.C |
| Other Organization Name | ST. MARYS GOOD SAMARITAN MEDICAL GROUP ULTRASOUND |
| Practice Address |
1708 Jefferson Ave Suite 100 Mount Vernon IL 62864-4309 |
| Mailing Address |
413 Main St Mount Vernon IL 62864-3649 |
| Practice Telephone | 6182411856 |
| Practice Fax Number | 6182411857 |
| Mailing Telephone | 6185329350 |
| Mailing Fax Number | 6185329365 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |
| Authorized Official Name | MR. RICHARD HUNTINGTON (VP FINANCIAL SERVICES) |
| Authorized Official Telephone | 6182412204 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS S.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| St. Marys Good Samaritan Medical Group Ultrasound | Doing Business As Name - Organization |
| Street Address |
1708 JEFFERSON AVE SUITE 100 |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-4309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912073784 | Womens Health Associates of Southern Illinois, S. C. | Obstetrics & Gynecology | 1708 Jefferson Ave, Mount Vernon, IL 62864-4309 | 2006-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144687617 | Montefiore New Rochelle | Clinic/Center | 100 Stevens Ave Fl 7, Mount Vernon, NY 10550-2610 | 2016-01-28 |
| 1013215466 | Sorin S Rhone | Clinic/Center | 1930 E College Way Ste B, Mount Vernon, WA 98273-2393 | 2011-03-09 |
| 1467601047 | Knox Community Hospital | Clinic/Center | 1355 Yauger Rd., Mount Vernon, OH 43050 | 2008-09-18 |
| 1285828467 | Pacific Coast Chiropractic | Clinic/Center | 1400 Riverside Dr Ste A, Mount Vernon, WA 98273-5001 | 2007-08-30 |
| 1649742602 | Samantha Leah Simon | Clinic/Center | 401 S 25th St, Mount Vernon, WA 98274-4772 | 2018-12-31 |
| 1356631535 | Walk In Clinic LLC | Clinic/Center | 207 W High St, Mount Vernon, OH 43050-2427 | 2011-04-08 |
| 1003065681 | Knox Community Hospital | Clinic/Center | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 | 2008-09-18 |
| 1801045406 | Knox Community Hospital | Clinic/Center | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 | 2008-09-18 |
| 1538318134 | Knox Community Hospital | Clinic/Center | 1330 Coshocton Ave, Mount Vernon, OH 43050-1440 | 2008-09-18 |
| 1962660902 | Barone Chiropractic Clinic P.s. | Clinic/Center | 124 N 18th St, Mount Vernon, WA 98273-3525 | 2008-05-27 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS S.C.
| 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.