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Organization

SIU PHYSICIANS & SURGEONS, INC

Active
Other names
SIU HealthCare
Organization subpart
No

Provider details

NPI number
Authorized official
SHELBY RENEE BURDICK (ASST MGR, MEDICAL STAFF SERVICES)
(217) 545-6523
Entity
Organization

Contact information

Practice address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
(844) 470-2488
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(844) 470-2488

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
IL
207ND0101X
MOHS-Micrographic Surgery Physician
IL
207Q00000X
Family Medicine Physician
IL
207R00000X
Internal Medicine Physician
IL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
IL
207RG0100X
Gastroenterology Physician
IL
207RR0500X
Rheumatology Physician
2084P0800X
Psychiatry Physician
IL
208M00000X
Hospitalist Physician
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001558385989
IL
01
CB2589
RR MEDICARE
IL
01
CE8686
RR MEDICARE
IL
01
CE8687
RR MEDICARE
IL
01
CE8688
RR MEDICARE
IL
01
CE8689
RR MEDICARE
IL
01
CE8931
RR MEDICARE
IL
Enumeration date
07/27/2006
Last updated
01/29/2024
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