Organization
SIU PHYSICIANS & SURGEONS, INC
Active
Other names
SIU HealthCare
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY KRUSE (CEO)
(217) 545-7876
Entity
Organization
Contact information
Practice address
315 W CARPENTER ST, SPRINGFIELD, IL 62702-4901
(217) 545-5817
(217) 545-1141
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
IL
332BC3200X
Customized Equipment (DME)
—
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/31/2011
Last updated
07/21/2022
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