Epilepsy Foundation of Greater Southern Illinois

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

199100111S Issued in IL

Legal business name

EPILEPSY FOUNDATION OF GREATER SOUTHERN ILLINOIS

Practice address

3515 N Belt W
Belleville, IL 62226-5944

Phone

(618) 236-2181

Fax

(618) 236-3654

NPI assigned

Dec 11, 2015

Last updated

Dec 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trudy L Baxter

Title

Executive Director

Phone

(618) 236-2181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1215302583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 N BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265944",
            "telephone_number": "618-236-2181",
            "fax_number": "618-236-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 N BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265944",
            "telephone_number": "618-236-2181",
            "fax_number": "618-236-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPILEPSY FOUNDATION OF GREATER SOUTHERN ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-236-2181"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IL",
            "license": "199100111S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichelle Enata, MD
• Carolyn Sue Endicott, MSW, LCSW
• Arthur T Engelage, D.M.D.
• Thomas E English, PHYSICAL THERAPIST
• James David Enyart, DC
• Hailey Nicole Erdman
• Michelle Nicole Ertel, CRNA
• Michelle Marie Quinn Eschman, M.S.
• Nahayo Esperant-Hilaire, MD
• Essence Express LLC

• Adult Care Home Facility in Belleville, IL
• Providers in Belleville, IL by specialty
• Adult Care Home Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.