Southern Illinois Internal Medicine LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHERN ILLINOIS INTERNAL MEDICINE LTD

Practice address

4600 Memorial Drive
Suite 310
Belleville, IL 62226-5366

Phone

(618) 235-8720

Fax

(618) 235-8725

NPI assigned

Oct 5, 2006

Last updated

Mar 7, 2008By 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

Mazhar H Lakho, MDNPI 1811997380

Title

Owner Physician

Phone

(618) 235-8720

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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.

• Mazhar H Lakho, MD

  • Internal Medicine Physician
  • Fairview Heights, IL
  • NPI 1811997380
  Medicare reassignment NPD Authorized official
• Rachel L Heft, NP

  • Family Nurse Practitioner
  • Troy, IL
  • NPI 1760846414
  Medicare reassignment NPD
• Holly Ackermann, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
  • NPI 1003303389
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1376630103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DRIVE",
            "address_2": "SUITE 310",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265366",
            "telephone_number": "618-235-8720",
            "fax_number": "618-235-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DRIVE",
            "address_2": "SUITE 310",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265366",
            "telephone_number": "618-235-8720",
            "fax_number": "618-235-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS INTERNAL MEDICINE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "LAKHO",
        "authorized_official_first_name": "MAZHAR",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "618-235-8720",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Healthcare Foundation, Inc. (Sihf Hilltop Center Facility)
• Southern Illinois Healthcare Foundation, Inc. (Illini Family Medicine)
• Southern Illinois Healthcare Foundation, Inc. (Belleville Pediatric & Adolescent Health Center)
• Southern Illinois Healthcare Foundation, Inc. (SIHF Healthcare)
• Southern Illinois Healthcare Foundation, Inc. (Children's Medical Center)
• Southern Illinois Neurologic Institute
• Southern Illinois Oral & Maxillofacial Surgery, LTD.
• Southern Illinois Otolaryngology, LTD
• Southern Illinois Physician Services, PC
• Southern Illinois Pulmonary Consultants, LTD.

• Internal Medicine Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.