# INTEGRATED HEALTH OF SOUTHERN ILLINOIS

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1790235497
- **Authorized official:** BRIAN HESTER (CEO)
- **Authorized official phone:** (618) 252-5555

## Contact information

- **Practice address:** 310 W PLAZA DR, CARTERVILLE, IL 62918-1980
- **Practice address phone:** (618) 985-9914
- **Mailing address:** 303 S COMMERCIAL ST, STE 10, HARRISBURG, IL 62946-2125
- **Mailing address phone:** (618) 252-5555
- **Mailing address fax:** (618) 252-2279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 10/06/2016
- **Last updated:** 10/06/2016