Organization
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW VERNEY M.D (PROGRAM DIRECTOR)
(217) 545-0193
Entity
Organization
Contact information
Practice address
701 N 1ST ST, ROOM D443, SPRINGFIELD, IL 62702-3757
(217) 545-0193
Mailing address
701 NORTH FIRST STREET, SPRINGFIELD, IL 62712
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
125063931
IL
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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