Individual provider Active NPI

Sidra Ilyas, M.D.

  • Internal Medicine Physician
  • Springfield, IL
National Provider Identifier
1801322136
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036157976 Issued in IL
Practice address
751 N Rutledge St Ste 1100
Springfield, IL 62702-4968
Phone
(217) 545-8000
NPI assigned
May 5, 2017
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036157976 IL Primary

Addresses

Primary practice location

751 N Rutledge St Ste 1100
Springfield, IL 62702-4968

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

Other practice location 1

4201 Saint Antoine St Rm 2E
Detroit, MI 48201-2153
Phone (718) 915-1758

Other practice location 2

400 N 9th St Fl 4
Springfield, IL 62702-5310
Phone (217) 545-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015001007 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5395143770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

751 N Rutledge St
Suite 1100
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036157976ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 29, 2021 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Nov 29, 2021 Accepting new patients
Siu Physicians & Surgeons, Inc Internal Medicine CurrentSince Nov 29, 2021 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Nov 29, 2021 Accepting new patients
Southern Illinois University Past Accepting new patients

Locations

201 E Madison St
Ste 328
Springfield, IL 62702

400 N 9th St
Springfield, IL 62702
Phone (217) 545-6498

400 N 9th St
Fl 4
Springfield, IL 62702

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

751 N Rutledge St
Ste 1100
Springfield, IL 62702
Phone (217) 545-0182

Interoperability endpoints

  • Direct secure messaging: sidrailyas@siusm.allscriptsdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1801322136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST STE 1100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St Rm 2E",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "718-915-1758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N 9th St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025310",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILYAS",
        "first_name": "SIDRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036157976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.