NPIMap

Organization Active NPI

Southern Illinois Vein Center, LLC

  • Surgery Physician
  • Marion, IL
National Provider Identifier
1295927697
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SOUTHERN ILLINOIS VEIN CENTER, LLC
Practice address
3106 Outer Dr
Suite 100
Marion, IL 62959-5270
Phone
(618) 998-8346
Fax
(618) 997-3942
NPI assigned
Aug 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. James Robelen, M.D.
Title
Owner
Phone
(618) 998-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X IL Primary

Addresses

Primary practice location

3106 Outer Dr
Suite 100
Marion, IL 62959-5270

Mailing address

3106 Outer Dr
Suite 100
Marion, IL 62959-5270
Phone (618) 998-8346

National Provider Directory

National Provider Directory

Locations

3106 Outer Dr
#100
Marion, IL 62959
Phone (618) 998-8346

8000 Aviation Dr
Marion, IL 62959
Phone (618) 998-8346

3106 Outer Dr
Ste 100
Marion, IL 62959
Phone (618) 997-8412

1000 Main St
Mount Vernon, IL 62864
Phone (618) 998-8346

2682 Olivet Church Rd
Paducah, KY 42001
Phone (618) 998-8346

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1295927697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 OUTER DR",
            "address_2": "SUITE 100",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595270",
            "telephone_number": "618-998-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 OUTER DR",
            "address_2": "SUITE 100",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595270",
            "telephone_number": "618-998-8346",
            "fax_number": "618-997-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS VEIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ROBELEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-998-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.