Med East SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MED EAST SC

Practice address

129 N 8TH St
Suite 228
East Saint Louis, IL 62201-2917

Phone

(618) 874-5016

NPI assigned

Mar 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Philip H Dennis, M.D.

Title

President

Phone

(618) 874-5016

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1174763171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VANDALIA ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251703",
            "telephone_number": "618-792-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N 8TH ST",
            "address_2": "SUITE 228",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622012917",
            "telephone_number": "618-874-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED EAST SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-874-5016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.