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Organization
SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC
Active
Organization
SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HARRIS MSHA, MBA, FACHE (CHIEF EXECUTIVE OFFICER)
(859) 537-7001
Entity
Organization
Contact information
Practice address
510 LINCOLN DR, HERRIN, IL 62948-6334
(618) 997-3100
(618) 997-3616
Mailing address
600 S CLIFF AVE STE 106, SIOUX FALLS, SD 57104-5355
(618) 997-3100
(618) 997-3616
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002421
IL
Other
Enumeration date
08/23/2005
Last updated
05/28/2024
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