NPIMap

Organization Active NPI

Southern Il Regional Social Services

  • Community/Behavioral Health Agency
  • Carbondale, IL
National Provider Identifier
1083851182
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
A-0243-0001-A Issued in IL
Legal business name
SOUTHERN IL REGIONAL SOCIAL SERVICES
Practice address
602 E College St
Carbondale, IL 62901-3309
Phone
(618) 457-6703
Fax
(618) 457-8377
NPI assigned
Jan 12, 2009
Last updated
Mar 9, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN IL REGIONAL SOCIAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Authorized official

Name
Ms. Karen S Freitag
Title
Executive Director
Phone
(618) 457-6703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X A-0243-0001-A IL Primary

Addresses

Primary practice location

602 E College St
Carbondale, IL 62901-3309

Mailing address

604 E College St
Carbondale, IL 62901-3309
Phone (618) 457-6703

Other names 1

  • Southern Illinois Regional Social Services, Inc. Other name

National Provider Directory

National Provider Directory
Part of
Southern Illinois Regional Social Services

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1083851182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E COLLEGE ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013309",
            "telephone_number": "618-457-6703",
            "fax_number": "618-457-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E COLLEGE ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013309",
            "telephone_number": "618-457-6703",
            "fax_number": "618-457-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN IL REGIONAL SOCIAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN IL REGIONAL SOCIAL SERVICES",
        "enumeration_date": "2009-01-12",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "FREITAG",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-457-6703",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-0243-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Illinois Regional Social Services, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.