NPIMap

Organization Active NPI

Southern Illinois Medical Care Associates, LLC

  • Family Medicine Physician
  • Marion, IL
National Provider Identifier
1114083169
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHERN ILLINOIS MEDICAL CARE ASSOCIATES, LLC
Practice address
3331 W Deyoung St
Suite 305
Marion, IL 62959-5896
Phone
(618) 998-7000
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sean McCain, M.D.
Title
Physician
Phone
(618) 998-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

3331 W Deyoung St
Suite 305
Marion, IL 62959-5896

Mailing address

PO Box 548
Marion, IL 62959-0548
Phone (618) 998-7000

Other names 1

  • SIMCA Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114083169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 548",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629590548",
            "telephone_number": "618-998-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 W DEYOUNG ST",
            "address_2": "SUITE 305",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595896",
            "telephone_number": "618-998-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS MEDICAL CARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCAIN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "618-998-7000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIMCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.