Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SIU PHYSICIANS & SURGEONS, INC
Active
Organization
SIU PHYSICIANS & SURGEONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TKACH (CEO)
(217) 545-7578
Entity
Organization
Contact information
Practice address
701 N 1ST ST, D235, SPRINGFIELD, IL 62781-0001
(217) 545-7578
(217) 545-1884
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
IL
2080P0202X
Pediatric Cardiology Physician
—
IL
2080P0203X
Pediatric Critical Care Medicine Physician
—
IL
2080P0207X
Pediatric Hematology & Oncology Physician
—
IL
2080P0214X
Pediatric Pulmonology Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB2589
RR MEDICARE
IL
01
—
CE8686
RR MEDICARE
IL
01
—
CE8687
RR MEDICARE
IL
01
—
CE8688
RR MEDICARE
IL
01
—
CE8689
RR MEDICARE
IL
01
—
CE8931
RR MEDICARE
IL
Enumeration date
07/25/2006
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up