South Side Office of Concern

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

04125 Issued in IL

Legal business name

SOUTH SIDE OFFICE OF CONCERN

Practice address

1316 SW Adams St
Peoria, IL 61602-1702

Phone

(309) 674-7310

Fax

(309) 674-9652

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Christine E Kahl, CADC

Title

Executive Director

Phone

(309) 674-7310

Specialties & licenses 1

Addresses

Tax ID family

South Side Office of Concern2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Side Office of Concern

  • Community/Behavioral Health Agency
  • Peoria, IL
  • NPI 1528482148
  NPD tax ID

Locations

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1174724280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 NE JEFFERSON STREET",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021212",
            "telephone_number": "309-674-7310",
            "fax_number": "309-674-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021702",
            "telephone_number": "309-674-7310",
            "fax_number": "309-674-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE OFFICE OF CONCERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "KAHL",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-674-7310",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CADC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "04125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Alexander Soria, MD
• Johan W Sosa de la Cruz, MD
• Joseph A Sottile, M.D.
• Mohammad G Soud, M.D.
• Sounds Good
• South Side Office of Concern
• Abdul Rehman Sozzer, D.O.
• Franklin M Spalding, DDS
• Stacey Ann Spalding
• Erica Spangler, APN

• Case Management Agency in Peoria, IL
• Providers in Peoria, IL by specialty
• Case Management Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.