# SIU PHYSICIANS & SURGEONS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SIU HealthCare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871882787
- **Authorized official:** JERRY KRUSE (CEO)
- **Authorized official phone:** (217) 545-7876

## Contact information

- **Practice address:** 315 W CARPENTER ST, SPRINGFIELD, IL 62702-4901
- **Practice address phone:** (217) 545-5817
- **Practice address fax:** (217) 545-1141
- **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 |
| --- | --- | --- | --- | --- |
| 207RH0000X | Hematology (Internal Medicine) Physician | — | NULL | — |
| 207RH0000X | Hematology (Internal Medicine) Physician | — | — | — |
| 207RX0202X | Medical Oncology Physician | — | NULL | — |
| 207RX0202X | Medical Oncology Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | IL | — |
| 332BC3200X | Customized Equipment (DME) | — | IL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/31/2011
- **Last updated:** 07/21/2022