Organization
SOUTHERN ILLINOIS SURGICAL APPLIANCE CO
Active
Other names
SISA Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT R LEWIS (PRESIDENT)
(618) 932-3157
Entity
Organization
Contact information
Practice address
207 EAST MAIN ST, DUQUOIN, IL 62832
(618) 542-3876
(618) 542-6157
Mailing address
19 WEST FRANKFORT PLAZA, WEST FRANKFORT, IL 62896
(618) 932-3157
(618) 932-3031
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
IN PROCESS
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
IN PROCESS
IL
Other
Enumeration date
09/08/2006
Last updated
09/11/2025
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