Southern Illinois Primary Care Associates, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

060009133 Issued in IL

Legal business name

SOUTHERN ILLINOIS PRIMARY CARE ASSOCIATES, P.C.

Practice address

33 W Main St
Albion, IL 62806-1006

Phone

(618) 842-4470

Fax

(618) 842-3437

NPI assigned

Apr 4, 2006

Last updated

Oct 6, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHERN ILLINOIS PRIMARY CARE ASSOCIATES, P.C.As reported in NPPES

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

Authorized official

Name

Cathy L Harte

Title

Director of Business Corp Secretary

Phone

(618) 842-4470

Specialties & licenses 6

Addresses

Part of

Southern Illinois Primary Care Associates PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Southern Illinois Primary Care Associates, P.C.

  • Family Medicine Physician
  • Fairfield, IL
  • NPI 1144405291
  NPPES parent name

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1689636888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 NW 11TH ST",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628371218",
            "telephone_number": "618-842-4470",
            "fax_number": "618-842-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W MAIN ST",
            "city": "ALBION",
            "state": "IL",
            "postal_code": "628061006",
            "telephone_number": "618-842-4470",
            "fax_number": "618-842-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS PRIMARY CARE ASSOCIATES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN ILLINOIS PRIMARY CARE ASSOCIATES, P.C.",
        "enumeration_date": "2006-04-04",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "HARTE",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS CORP SECRETARY",
        "authorized_official_telephone_number": "618-842-4470"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "060009133",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "060009133",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "060009133",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "060009133",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "060009133",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "060009133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Albion, IL
• Providers in Albion, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.