Premier Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036092117 Issued in IL

Legal business name

PREMIER INTERNAL MEDICINE LLC

Practice address

4500 Memorial Dr
Belleville, IL 62226-5360

Phone

(618) 476-9399

Fax

(618) 476-9547

NPI assigned

Dec 27, 2005

Last updated

Oct 2, 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

Syed K Hussain, MDNPI 1205813714

Title

MD

Phone

(314) 304-1769

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Syed K Hussain, MD.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1205813714
  NPD Authorized official

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1689651184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1347 ARBOR BLUFF CIR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630213701",
            "telephone_number": "618-476-9399",
            "fax_number": "618-476-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-476-9399",
            "fax_number": "618-476-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "HUSSAIN",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "314-304-1769",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036092117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092117",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sobhana Krishna Potluri, MD
• Nicholas E Poulos, MD
• Chloe Powell
• Veronica Powers
• Prairie Psychiatry, SC
• Premier Pathology Services LLC
• Premise Health of Illinois Medical PC (St Claire - Belleville)
• Sarah Price, M.D.
• Susan Elizabeth Price, SSP, MAED
• Kosit Prieb, M.D.

• 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 Oct 2, 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.