NPIMap

Organization Active NPI

So Illinois Neurology & Rehab

  • Specialist
  • Mount Vernon, IL
National Provider Identifier
1174648737
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036-051778 Issued in IL
Legal business name
SO ILLINOIS NEUROLOGY & REHAB
Practice address
1702 Broadway St
Suite C
Mount Vernon, IL 62864-2930
Phone
(618) 242-6465
Fax
(618) 242-6463
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. Pritam S Sahni, M.D.
Title
Owner
Phone
(618) 242-6465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036-051778 IL Primary

Addresses

Primary practice location

1702 Broadway St
Suite C
Mount Vernon, IL 62864-2930

Mailing address

1702 Broadway St
Suite C
Mount Vernon, IL 62864-2930
Phone (618) 242-6465

National Provider Directory

National Provider Directory

Locations

1702 Broadway St
Ste C
Mount Vernon, IL 62864
Phone (618) 242-6465

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1174648737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 BROADWAY ST",
            "address_2": "SUITE C",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642930",
            "telephone_number": "618-242-6465",
            "fax_number": "618-242-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 BROADWAY ST",
            "address_2": "SUITE C",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642930",
            "telephone_number": "618-242-6465",
            "fax_number": "618-242-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO ILLINOIS NEUROLOGY & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "SAHNI",
        "authorized_official_first_name": "PRITAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-242-6465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-051778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.