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Organization
PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC
Active
Organization
PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC
Active
Other names
SSM Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEE EVISCHI (VP FINANCE MEDICAL GROUP)
(618) 899-1040
Entity
Organization
Contact information
Practice address
1441 W BROADWAY, CENTRALIA, IL 62801-0001
(618) 532-9050
Mailing address
1411 W BROADWAY, CENTRALIA, IL 62801-0001
(618) 532-9050
(618) 532-9365
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
0002642
IL
Other
Enumeration date
06/08/2005
Last updated
08/26/2015
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