Sidra Ilyas, M.D.
Individual provider Active NPI Internal Medicine Physician · Springfield, IL
NPI 1801322136 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1801322136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036157976 (IL)
- Practice address
- 751 N Rutledge St Ste 1100
Springfield, IL 62702-4968 - Phone
- (217) 545-8000
- NPI assigned
- May 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 23
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Board of Trustees of Southern Illinois University
Practice addresses (Care Compare)
751 N Rutledge St
Suite 1100
Springfield, IL 62702-4968
Phone (217) 545-8000
Hospital & facility affiliations
- Memorial Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211015001007 | IL | Practitioner - Internal Medicine |
5395143770 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036157976 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of Southern Illinois University | Current |
Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current |
Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Internal Medicine | Current |
Accepting new patients |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current |
Accepting new patients | |
| Southern Illinois University | Past | Accepting new patients |
Locations
751 N Rutledge St
Ste 1100
Springfield, IL 62702
Phone (217) 545-0182
201 E Madison St
Ste 328
Springfield, IL 62702
400 N 9th St
Springfield, IL 62702
Phone (217) 545-6498
520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100
751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182
400 N 9th St
Fl 4
Springfield, IL 62702
Interoperability endpoints
- sidrailyas@siusm.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 036157976 | IL | Yes |
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
Other providers in Springfield, IL
- Illinois Department of Public Health
- Illinois Diagnostic Imaging, Inc
- Illinois Pharmacists Management Enterprises, LLC
- Illinois Spine Center SC
- Morayo Ilubanwo
- Kevin Andrew Imhoff
- Kevin Wayne Imhoff
- Impactful Counseling Services, P.L.L.C.
- In-Depth Nonemergency Medical Transportation LLC
- Christopher Inabnit
All providers in Springfield, IL · Internal 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 Oct 13, 2021. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.