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Contact Information

SOUTHERN ILLINOIS ASSOCIATES LLC
6805 STATE ROUTE 162 STE 201
MARYVILLE, IL62062-8530
 Phone: 618-288-5019
 Fax: 618-288-5059
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SOUTHERN ILLINOIS ASSOCIATES LLC · (Female)

NPI # 1962427856
Status Active
Credentials
Entity Individual
Enumeration date 07/13/2006
Last updated 04/06/2026 - About 2 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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