Epilepsy Foundation of Southern Illinois

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

EPILEPSY FOUNDATION OF SOUTHERN ILLINOIS

Practice address

1100 S 42ND St
Mount Vernon, IL 62864-6216

Phone

(618) 244-6680

Fax

(618) 244-6686

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Sara Stubblefield, LCSW

Title

Epilepsy Services Coordinator

Phone

(618) 244-6680

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124153879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S 42ND ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646216",
            "telephone_number": "618-244-6680",
            "fax_number": "618-244-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S 42ND ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646216",
            "telephone_number": "618-244-6680",
            "fax_number": "618-244-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPILEPSY FOUNDATION OF SOUTHERN ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STUBBLEFIELD",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "EPILEPSY SERVICES COORDINATOR",
        "authorized_official_telephone_number": "618-244-6680",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michell R Ellis, PHARMD
• Dennis J Els, OD
• Edgardo S Emilia, MD
• Cheryl L Emmons, MD
• Amanda Engele, FNP-C
• Ernst Radiology Clinic, Inc
• Bethany Ann Essner, PT
• Johanna Shea Estes, RD, IBCLC, MSNFNP-C
• Kent Alan Fair, CRNA
• Fairview Heights Medical Group SC

• Voluntary or Charitable Agency in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Voluntary or Charitable Agency in Illinois

• 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.