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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
133V00000X
Registered Dietitian
—
IL
225XH1200X
Hand Occupational Therapist
—
IL
231H00000X
Audiologist
—
IL
363AM0700X
Medical Physician Assistant
Primary
—
IL
363AS0400X
Surgical Physician Assistant
—
IL
363LA2100X
Acute Care Nurse Practitioner
—
IL
363LA2200X
Adult Health Nurse Practitioner
—
IL
363LF0000X
Family Nurse Practitioner
—
IL
363LN0000X
Neonatal Nurse Practitioner
—
IL
363LP0200X
Pediatric Nurse Practitioner
—
IL
364SG0600X
Gerontology Clinical Nurse Specialist
—
IL
364SX0200X
Oncology Clinical Nurse Specialist
—
IL
367A00000X
Advanced Practice Midwife
—
IL
Other
Enumeration date
07/26/2006
Last updated
07/21/2022
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