Organization
SOUTHERN ILLINOIS GI SPECIALISTS LLC
Active
Organization
SOUTHERN ILLINOIS GI SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAHOOR A MAKHDOOM MD (MD OWNER)
(618) 549-8006
Entity
Organization
Contact information
Practice address
1100 W DIANN LN, CARBONDALE, IL 62901-5339
(618) 549-8006
(618) 549-8434
Mailing address
PO BOX 365, CARBONDALE, IL 62903-0365
(618) 476-9399
(618) 476-9547
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036094155
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094155
—
IL
01
—
03926864
BCBS IL
IL
01
—
063398
HEALTH ALLIANCE HMO
—
01
—
435384
HEALTHLINK
—
Enumeration date
03/28/2006
Last updated
08/12/2008
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