Southernmost Illinois Community Health Improvement Corporation
Organization Active NPI Radiology Clinic/Center · Cairo, IL
NPI 1770920183 · NPPES record last updated Dec 16, 2013
Key facts
- NPI
- 1770920183
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiology Clinic/Center 261QR0200X
- Legal business name
- SOUTHERNMOST ILLINOIS COMMUNITY HEALTH IMPROVEMENT CORPORATION
- Practice address
- 13289 Kessler Rd
Cairo, IL 62914-3101 - Phone
- (618) 734-1500
- Fax
- (618) 734-3949
- NPI assigned
- May 24, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHERNMOST ILLINOIS COMMUNITY HEALTH IMPROVEMENT CORPORATION
Authorized official
- Name
- Frederick Bernstein
- Title
- Ceo
- Phone
- (618) 457-0450
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140205000082 | IL | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 9032344098 | Practice locations: Cairo, IL |
National Provider Directory
- Part of
- Southernmost Illinois C
Locations
13289 Kessler Rd
Ste 153
Cairo, IL 62914
13289 Kessler Rd
#156
Cairo, IL 62914
Phone (618) 734-1500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Yes |
Addresses
Primary practice location
13289 Kessler Rd
Cairo, IL 62914-3101
Mailing address
13289 Kessler Rd
Cairo, IL 62914-3101
Phone (618) 734-1500
Other names
- Cairo Diagnostic Center Radiology
Other providers in Cairo, IL
- Tasha Simmerman
- Sarah Sims
- Southernmost Illinois Community Health Improvement Corporation
- Southernmost Illinois Community Health Improvement Corporation
- Southernmost Illinois Community Health Improvement Corporation
- Southernmost Illinois Community Health Improvement Corporation
- Latrina Spence
- Carol Stout
- Kimberly Jane Turner
- Vna Homecare, Inc.
All providers in Cairo, IL · Radiology Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.