SOUTHERN OBSTETRIC & GYNECO ASSOCIATES (NPI# 1881958981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881958981 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OBSTETRIC & GYNECO ASSOCIATES |
| Other Organization Name | SOUTHERN OB/GYN |
| Practice Address |
1201 Ricker Rd Salem IL 62881-4263 |
| Mailing Address |
9447 Holy Cross Ln Breese IL 62230-3510 |
| Practice Telephone | 6185262209 |
| Practice Fax Number | 6185267372 |
| Mailing Telephone | 6185262209 |
| Mailing Fax Number | 6185267372 |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |
| Authorized Official Name | DR. ANNE E DOLL-POLLARD (PRESIDENT) |
| Authorized Official Telephone | 6185262209 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 042005236 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | COPORATE LICENSE | 042005236 | 01 |
| Other Name | Type Code |
|---|---|
| Southern OB/GYN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962793687 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 1328 Mercantile Dr, Highland, IL 62249-1257 | 2011-04-28 |
| 1467419804 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2006-04-28 |
| 1134484249 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 211 E Hanover St, New Baden, IL 62265-1811 | 2012-07-05 |
| 1174887277 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2012-07-03 |
| 1205199452 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 700 S Dewey St, Greenville, IL 62246-2288 | 2012-06-22 |
| Street Address |
1201 RICKER RD |
| City | SALEM |
| State | IL |
| Zip Code | 62881-4263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184686115 | Michael J Hourigan | Registered Nurse | 1201 Ricker Rd, Salem, IL 62881-4263 | 2006-04-05 |
| 1174136626 | Christopher Evan Meier | Physical Therapist | 1201 Ricker Rd, Salem, IL 62881-4263 | 2020-08-25 |
| 1407407885 | Tracy Adele Caswell | Nurse Practitioner | 1201 Ricker Rd, Salem, IL 62881-4263 | 2019-09-26 |
| 1215455621 | Emily Harrell | Physical Therapist | 1201 Ricker Rd, Salem, IL 62881-4263 | 2017-09-06 |
| 1770998049 | Total Renal Care Inc | Clinic/Center | 1201 Ricker Rd, Salem, IL 62881-4263 | 2014-06-25 |
| 1710307681 | Deidre Langston | Nurse Practitioner | 1201 Ricker Rd, Salem, IL 62881-4263 | 2014-04-18 |
| 1881964948 | Keri A Paulson | Occupational Therapist | 1201 Ricker Rd, Salem, IL 62881-4263 | 2012-01-06 |
| 1508134396 | Stephanie D Branch | Nurse Practitioner | 1201 Ricker Rd, Salem, IL 62881-4263 | 2011-12-07 |
| 1356578819 | Jan Michael Pastrana Aguiling | Physical Therapist | 1201 Ricker Rd, Salem, IL 62881-4263 | 2009-06-11 |
| 1457599847 | Sherry L Lynch | Nurse Practitioner | 1201 Ricker Rd, Salem, IL 62881-4263 | 2009-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447776026 | Heather Krajefska | Speech-Language Pathologist | Franklin Park School, 1325 N Franklin, Salem, IL 62881 | 2017-08-16 |
| 1629510581 | Heidi V. Thompson | Nurse Practitioner | 1250 W. Whittaker, Salem, IL 62881 | 2016-11-09 |
| 1548664170 | Catherine Durbin | Nurse Practitioner | 518 South Broadway, Salem, IL 62881 | 2014-10-10 |
| 1770718439 | Community Resource Center, Inc | Community/Behavioral Health | 315 Westgate, Salem, IL 62881 | 2009-05-26 |
| 1932377652 | Community Resource Center Inc | Clinic/Center | 315 Westgate Ave, Salem, IL 62881 | 2008-02-15 |
| 1245408053 | The Manor At Salem Woods, L.p. | Assisted Living Facility | 441 S. Hotze Rd., Salem, IL 62881 | 2008-02-14 |
| 1366610321 | Penta Group Inc. | Non-emergency Medical Transport (VAN) | 300 Schoonover Drive, Salem, IL 62881 | 2008-02-13 |
| 1326192808 | Alan D Montgomery | Optometrist | 400 North Broadway, Salem, IL 62881 | 2007-01-22 |
| 1669539979 | Knevitt Inc | Ambulance | 3340 Selmaville Rd, Salem, IL 62881 | 2007-01-03 |
| 1447314737 | Gautam Jha | Internal Medicine | 1325 W. Whittaker, Suite D, Salem, IL 62881 | 2006-12-20 |
| Find all providers in zip 62881 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629308994 | Dale Alan Cruise | Obstetrics & Gynecology | 3622 El Dorado Loop S, Salem, OR 97302-9737 | 2010-01-07 |
| 1083845721 | Betsy S August Md LLC | Obstetrics & Gynecology | 55 Highland Ave Ste 103, Salem, MA 01970-2100 | 2009-07-29 |
| 1013159292 | Shruti Satyanarayan Biyani | Obstetrics & Gynecology | 18 Keewaydin Drive, Salem, NH 03079 | 2009-04-02 |
| 1326210063 | Pacific Obstetrics & Gynecology, L.L.C. | Obstetrics & Gynecology | 700 Bellevue St Se Ste 210, Salem, OR 97301-3855 | 2008-04-01 |
| 1588770325 | Darcy Lynn Blanchard | Obstetrics & Gynecology | 2020 Capitol St. Se, Salem, OR 97301 | 2006-08-22 |
| 1548375074 | Thomas A Murray IIi | Obstetrics & Gynecology | 55 Highland Ave Ste 302, Salem, MA 01970 | 2006-08-21 |
| 1134132368 | Mary Therese Brady | Obstetrics & Gynecology | 4 Nowell Ct, Salem, NH 03079-1228 | 2006-08-15 |
| 1205846854 | Fu-nen Lee | Obstetrics & Gynecology | 2376 Southeast Blvd, Salem, OH 44460-3472 | 2006-08-08 |
| 1386682409 | Cheryl A Lugenbill | Obstetrics & Gynecology | 939 Oak St Se, Salem, OR 97301 | 2006-06-02 |
| 1871551705 | William H Edwards | Obstetrics & Gynecology | 45 Stiles Rd, Suite 101, Salem, NH 03079-4808 | 2006-05-02 |
| Find all providers in SALEM | ||||
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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.