# SIU PHYSICIANS & SURGEONS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427071646
- **Authorized official:** DAVID TKACH (CEO)
- **Authorized official phone:** (217) 545-7578

## Contact information

- **Practice address:** 701 N 1ST ST, D235, SPRINGFIELD, IL 62781-0001
- **Practice address phone:** (217) 545-7578
- **Practice address fax:** (217) 545-1884
- **Mailing address:** PO BOX 19639, SPRINGFIELD, IL 62794-9639
- **Mailing address phone:** (217) 545-7578
- **Mailing address fax:** (217) 545-1884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | IL | — |
| 225XH1200X | Hand Occupational Therapist | — | IL | — |
| 231H00000X | Audiologist | — | IL | — |
| 363AM0700X | Medical Physician Assistant | — | IL | Yes |
| 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