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Contact Information

SOUTHERN ILLINOIS CENTER FOR INDEPENDENT LIVING
2135 W. RAMADA LANE
CARBONDALE, IL62901-5326
 Phone: 618-457-3318
 Fax: 618-549-0132
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
 

In Home Supportive Care

253Z00000X
 

Voluntary or Charitable

251V00000X 61 Voluntary Health or Charitable Agency[1]
Indicates primary specialty

NPI Profile & details for SOUTHERN ILLINOIS CENTER FOR INDEPENDENT LIVING

NPI # 1043867112
LBN Legal business name SOUTHERN ILLINOIS CENTER FOR INDEPENDENT LIVING
Authorized official BONNIE VAUGHN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/22/2019
Last updated 08/22/2019 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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