Southern Il Regional Social Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A0243-0001-A Issued in IL

Legal business name

SOUTHERN IL REGIONAL SOCIAL SERVICES, INC.

Practice address

604 E College St
Carbondale, IL 62901-3309

Phone

(618) 457-6703

Fax

(618) 457-8377

NPI assigned

Jul 27, 2007

Last updated

Jan 8, 2011By 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

Ms. Karen S Freitag

Title

Executive Director

Phone

(618) 457-6703

Specialties & licenses 2

Addresses

Other names 1

• Southern Illinois Regional Social Services, inc. Other name

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294444800000",
    "number": "1326238148",
    "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": "604 E COLLEGE ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013309",
            "telephone_number": "618-457-6703",
            "fax_number": "618-457-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN IL REGIONAL SOCIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2011-01-08",
        "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": "180006282",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A0243-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Illinois Regional Social Services, inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sumeet Soni, MD
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• Community/Behavioral Health Agency in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2011; 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.