Siu Physicians & Surgeons, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SIU PHYSICIANS & SURGEONS, INC

Practice address

610 N Westgate Ave
Jacksonville, IL 62650-1152

Phone

(217) 243-8455

NPI assigned

Jun 11, 2018

Last updated

Sep 25, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jo Turley

Title

Medical Staff Coordinator

Phone

(217) 545-7876

Specialties & licenses 1

Addresses

Other names 2

• SIU HealthCare Other name
• SIU Womens Health Center Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1053804443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N WESTGATE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501152",
            "telephone_number": "217-243-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIU PHYSICIANS & SURGEONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "TURLEY",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "MEDICAL STAFF COORDINATOR",
        "authorized_official_telephone_number": "217-545-7876"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIU HealthCare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SIU HealthCare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SIU Womens Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.