Organization Active NPI

Allergy, Asthma & Immunology Center SC

  • Allergy & Immunology Physician
  • Shiloh, IL
National Provider Identifier
1184829210
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ALLERGY, ASTHMA & IMMUNOLOGY CENTER SC
Practice address
325 Tamarack LN
Shiloh, IL 62269-2993
Phone
(618) 624-2060
Fax
(618) 624-2226
NPI assigned
Jun 19, 2007
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Dr. Patrick Win, MDNPI 1346335783
Title
President
Phone
(618) 624-2060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

325 Tamarack LN
Shiloh, IL 62269-2993

Mailing address

325 Tamarack LN
Shiloh, IL 62269-2993
Phone (618) 624-2060

Other practice location 1

425 N New Ballas Rd Ste 203
Saint Louis, MO 63141-6848
Phone (314) 872-3104

Other practice location 2

2023 Vadalabene Dr Ste 151
Maryville, IL 62062-5845
Phone (618) 624-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070714000154 IL Part B Supplier - Clinic/Group Practice 9830299247 Receives reassigned benefits from 6 practitioners
Practice locations: Maryville, IL; Shiloh, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2330086Allergy, Asthma & Immunology Center2023 Vadalabene Dr - Ste 151, Maryville, IL 62062Provider-performed microscopySep 9, 2027
14D2330100Allergy, Asthma & Immunology Center325 Tamarack Lane, Shiloh, IL 62269Provider-performed microscopySep 9, 2027

National Provider Directory

National Provider Directory

Locations

2023 Vadalabene Dr
Ste 151
Maryville, IL 62062
Phone (618) 624-2060

325 Tamarack Ln
Shiloh, IL 62269
Phone (618) 624-2060

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1184829210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 TAMARACK LN",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692993",
            "telephone_number": "618-624-2060",
            "fax_number": "618-624-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 TAMARACK LN",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692993",
            "telephone_number": "618-624-2060",
            "fax_number": "618-624-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 N New Ballas Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416848",
            "country_code": "US",
            "telephone_number": "314-872-3104",
            "fax_number": "314-994-7105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2023 Vadalabene Dr Ste 151",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625845",
            "country_code": "US",
            "telephone_number": "618-624-2060",
            "fax_number": "618-624-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLERGY, ASTHMA & IMMUNOLOGY CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "WIN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-624-2060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.