Southern Illinois Medical Care Associates LLC
Organization Active NPI Family Medicine Physician · Marion, IL
NPI 1720183320 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1720183320
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SOUTHERN ILLINOIS MEDICAL CARE ASSOCIATES LLC
- Practice address
- 3411 Professional Park Dr
Marion, IL 62959-6394 - Phone
- (618) 997-2161
- NPI assigned
- Sep 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Laura J Fey
- Title
- Sr. Director Physician Rev Cycle
- Phone
- (615) 221-3641
Practitioners 10
-
Peggy Boyd, NP
-
Jeri Lynn Brinkley, PA-C
-
Tamara Collard, P.A.
-
Moya Racquel Cook, FNP
-
Carmella Jo Doss, P.A.
-
Randall S. Pass, MD
-
Rebecca L. Sloan, NP
-
Amin A Lakhdhir, M.D.
-
Michael Wata Luy, MD
-
Karl Taira, MD
National Provider Directory
Locations
3022 S Park Ave
Herrin, IL 62948
Phone (618) 942-3334
3331 W Deyoung St
Ste 106
Marion, IL 62959
Phone (618) 998-9910
3331 W Deyoung St
Ste 301
Marion, IL 62959
Phone (618) 998-7062
2700 W Deyoung St
Ste G
Marion, IL 62959
Phone (615) 998-1900
2700 W Deyoung St
Ste F
Marion, IL 62959
Phone (618) 457-5330
406 W Saint Louis St
West Frankfort, IL 62896
Phone (618) 937-0890
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Nurse Practitioner |
363L00000X | IL |
Addresses
Primary practice location
3411 Professional Park Dr
Marion, IL 62959-6394
Mailing address
1573 Mallory LN Ste 100
Brentwood, TN 37027-2895
Phone (615) 221-1400
Other providers in Marion, IL
- Southern Illinois Hospital Services
- Southern Illinois Hospital Services
- Southern Illinois Hospital Services
- Southern Illinois Hospital Services
- Southern Illinois Hospital Services
- Southern Illinois Medical Care Associates, LLC
- Southern Illinois Oncology & Hematology LTD
- Southern Illinois Pain Management
- Southern Illinois Psychiatry LLC
- Southern Illinois Sleep Institute
All providers in Marion, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.