NPIMap

Organization Active NPI

Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1285657379
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SIU PHYSICIANS & SURGEONS, INC
Practice address
701 N 1St St
D235
Springfield, IL 62781-0001
Phone
(217) 545-7578
Fax
(217) 545-1884
NPI assigned
Jul 26, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
David Tkach
Title
Ceo
Phone
(217) 545-7578

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207SG0201X IL
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X IL Primary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X IL
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X IL
Pediatric Infectious Diseases PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0208X IL
Pediatric Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0210X IL

Addresses

Primary practice location

701 N 1St St
D235
Springfield, IL 62781-0001

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-7578

Other identifiers 6

IdentifierTypeStateIssuer
CE8688OtherILRR MEDICARE
CE8689OtherILRR MEDICARE
CE8687OtherILRR MEDICARE
CE8931OtherILRR MEDICARE
CE8686OtherILRR MEDICARE
CB2589OtherILRR MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Siu Physicians Surgeons in10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations (25 of 75)

1155 E Vienna St
Ste C
Anna, IL 62906
Phone (618) 833-6488

3024 E Empire St
Bloomington, IL 61704
Phone (309) 556-7500

305 W Jackson St
Carbondale, IL 62901
Phone (618) 529-8800

441 W Hay St
#1
Decatur, IL 62526

2 Memorial Dr
Decatur, IL 62526
Phone (217) 872-2943

441 W Hay St
Fl 2
Decatur, IL 62526
Phone (217) 876-6860

441 W Hay St
#2
Decatur, IL 62526

2 Memorial Dr
Fl 1
Decatur, IL 62526
Phone (217) 872-2930

1770 E Lake Shore Dr
Ste 120
Decatur, IL 62521

1750 E Lake Shore Dr
Ste 307
Decatur, IL 62521

515 N College St
Lowr
Lincoln, IL 62656

1201 E Union Ave
Litchfield, IL 62056
Phone (217) 324-1100

1215 Franciscan Dr
Fl 2
Litchfield, IL 62056
Phone (217) 324-8420

2010 Jacobssen Dr
Normal, IL 61761
Phone (309) 452-0995

810 4th St
Pawnee, IL 62558
Phone (217) 625-2471

1027 Maine St
Fl 1
Quincy, IL 62301

1005 Broadway St
Fl 2
Quincy, IL 62301

1025 Maine St
#1
Quincy, IL 62301

1027 Maine St
Quincy, IL 62301

841 N 3rd St
Riverton, IL 62561

747 N Rutledge St
#5
Springfield, IL 62702

301 N 8th St
#3B
Springfield, IL 62701

619 E Mason St
Ste 5619E
Springfield, IL 62701

301 N 8th St
Ste 4B
Springfield, IL 62701

315 W Carpenter St
#B
Springfield, IL 62702

Practitioners & affiliated clinicians

Practitioners 328

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.

View all 328

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285657379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "address_2": "D235",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIU PHYSICIANS & SURGEONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TKACH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-545-7578"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8688",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8689",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8687",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8931",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8686",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CB2589",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.