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Contact Information

SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC
4600 MEMORIAL DRIVE
SUITE 340
BELLEVILLE, IL62226
 Phone: 618-222-9999
 Fax: 618-222-9337
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC

NPI Number 1508953746
LBN Legal business name SOUTHERN ILLINOIS PHYSICIAN SERVICES, PC
Authorized official REBECCA TIBEREND - (BILLING OFFICER SUPERVISOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/09/2006
Last updated 06/21/2018 - About 8 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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