Siu Physicians & Surgeons, Inc

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

SIU PHYSICIANS & SURGEONS, INC

Practice address

720 N Bond St
Springfield, IL 62702-4952

Phone

(217) 545-8000

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Jerry Kruse, MD

Title

Ceo

Phone

(217) 545-7876

Specialties & licenses 10

Addresses

Other identifiers 6

Tax ID family

Siu Physicians Surg10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

• Siu Physicians & Surgeons, Inc

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1093739435
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Neonatal-Perinatal Medicine Physician
  • Springfield, IL
  • NPI 1275556771
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
  • NPI 1285657379
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Case Management Agency
  • Springfield, IL
  • NPI 1396211975
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Medical Physician Assistant
  • Springfield, IL
  • NPI 1427071646
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Neurology Physician
  • Springfield, IL
  • NPI 1467476895
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Cardiovascular Disease Physician
  • Springfield, IL
  • NPI 1780607291
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Health Educator
  • Springfield, IL
  • NPI 1821716135
  NPD tax ID
• Siu Physicians & Surgeons, Inc

  • Customized Equipment (DME)
  • Springfield, IL
  • NPI 1942849096
  NPD tax ID

Locations

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790705507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N BOND ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024952",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_2": "D235",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627023757",
            "country_code": "US",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIU PHYSICIANS & SURGEONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-545-7876",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8689",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8688",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8686",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8687",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CB2589",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8931",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Peyton Six, BCBA

• Neurological Surgery Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.