WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC (NPI# 1871132449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871132449 |
| Entity Type | Organization |
| Organization Name | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC |
| Practice Address |
19 Wolf Creek Dr Swansea IL 62226-2355 |
| Mailing Address |
660 South Euclid Avenue Campus Box 8115 St. Louis MO 63110 |
| Practice Telephone | 6182353687 |
| Practice Fax Number | 3143627522 |
| Mailing Telephone | 3143627395 |
| Mailing Fax Number | 3143627522 |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |
| Authorized Official Name | MS. CATHY EGHIGIAN (DIRECTOR, CREDENTIALING OPERATIONS) |
| Authorized Official Telephone | 1432730770 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WUPI - Department of Otolaryngology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12860 Troxler Ave, Highland, IL 622492898 | 6182353687 | |
| 9515 Holy Cross Ln Ste 2, Breese, IL 622303618 | 6182353687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
| 1760946156 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2019-01-30 |
| 1891265039 | Washington University Physicians In Illinois, Inc | Physical Therapist | 1414 Cross St, O Fallon, IL 62269-2988 | 2018-11-30 |
| 1356822993 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2018-08-22 |
| 1477076263 | Washington University Physicians In Illinois, Inc | Clinic/Center | 1414 Cross St, O Fallon, IL 62269-2988 | 2017-07-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WASHINGTON UNIVERSITY PHYSICIANS IN ILLINOIS, INC. | 1414 Cross St, O Fallon, IL 62269-2988 |
| Street Address |
19 WOLF CREEK DR |
| City | SWANSEA |
| State | IL |
| Zip Code | 62226-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203617 | Murray D Mcgrady | Otolaryngology | 19 Wolf Creek Dr, Dept Otolaryngology, Swansea, IL 62226-2355 | 2005-05-24 |
| 1982122719 | Samantha M Menezes | Audiologist | 19 Wolf Creek Dr, Dept Otolaryngology, Swansea, IL 62226-2355 | 2017-08-31 |
| 1639532609 | Angela L Long | Nurse Practitioner | 19 Wolf Creek Dr, Dept Otolaryngology, Swansea, IL 62226-2355 | 2016-03-29 |
| 1265755649 | Shanna Lea Moshure | Audiologist | 19 Wolf Creek Dr, Dept Otolaryngology, Swansea, IL 62226-2355 | 2010-03-12 |
| 1235319245 | Susan D Hamilton | Audiologist | 19 Wolf Creek Dr, Swansea, IL 62226-2355 | 2007-11-07 |
| 1194825174 | Ear, Nose & Throat Institute of Southern Illinois Ltd. | Otolaryngology | 19 Wolf Creek Dr, Swansea, IL 62226-2355 | 2006-09-22 |
| 1033131164 | Dawn Marie Roulanaitis | Audiologist | 19 Wolf Creek Dr, Swansea, IL 62226-2355 | 2006-07-25 |
| 1689697187 | Brandy R Wojciuch | Audiologist | 19 Wolf Creek Dr, Swansea, IL 62226-2355 | 2006-07-25 |
| 1649273319 | Carl Wesley Lee II | Otolaryngology | 19 Wolf Creek Dr, Dept Otolaryngology, Swansea, IL 62226-2355 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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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.