NPIMap

Organization Active NPI

Southern Illinois Regional Social Services

  • Community/Behavioral Health Agency
  • Carbondale, IL
National Provider Identifier
1265679369
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
A-0243-0001-A Issued in IL
Legal business name
SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES
Practice address
608 W Main St
Carbondale, IL 62901-2604
Phone
(618) 457-6703
Fax
(618) 457-8377
NPI assigned
Jan 12, 2009
Organization subpart
Yes
Parent organization
SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Authorized official

Name
Ms. Karen S. Freitag
Title
Executive Director
Phone
(618) 457-6703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X A-0243-0001-A IL Primary

Addresses

Primary practice location

608 W Main St
Carbondale, IL 62901-2604

Mailing address

604 E College St
Carbondale, IL 62901-3309
Phone (618) 457-6703

Other names 1

  • SIRSS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Illinois Regional Social Services5 organizations share this tax ID, including this one
Part of
Southern Illinois Regional Social Services

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1265679369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E COLLEGE ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013309",
            "telephone_number": "618-457-6703",
            "fax_number": "618-457-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 W MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629012604",
            "telephone_number": "618-457-6703",
            "fax_number": "618-457-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES",
        "enumeration_date": "2009-01-12",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "FREITAG",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-457-6703",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-0243-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIRSS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.