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Contact Information

SOUTHERN ILLINOIS MEDICAL SPECIALISTS, LLC
107 W FRANKLIN ST
SESSER, IL62884-1456
 Phone: 618-625-2105
 Fax: 618-625-2108
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Independent Medical Examiner

202C00000X
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Neuromusculoskeletal Medicine & OMM

204D00000X 12 Physician/Osteopathic Manipulative Medicine
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for SOUTHERN ILLINOIS MEDICAL SPECIALISTS, LLC

NPI # 1134530173
LBN Legal business name SOUTHERN ILLINOIS MEDICAL SPECIALISTS, LLC
Authorized official LEE BEE - (CEO/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/13/2014
Last updated 05/13/2014 - About 12 years ago
Identifiers
IL License # 036125672
IL License # 14D2034829
IL Medicaid 036125672
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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