NPIMap

Organization Active NPI

Siu Physicians & Surgeons, Inc

  • Health Educator
  • Springfield, IL
National Provider Identifier
1821716135
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
SIU PHYSICIANS & SURGEONS, INC
Doing business as
SIU Center for Diabetes and Metabolic Health
Practice address
751 N Rutledge St Ste 1700
Springfield, IL 62702-4968
Phone
(217) 545-8000
NPI assigned
Aug 22, 2022
Organization subpart
Yes
Parent organization
SIU PHYSICIANS & SURGEONS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Authorized official

Name
Shelby Renee Burdick
Title
Team Lead, Medical Staff Services
Phone
(217) 545-6523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

751 N Rutledge St Ste 1700
Springfield, IL 62702-4968

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131

Other names 1

  • SIU Center for Diabetes and Metabolic Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Siu Physicians Surg10 organizations share this tax ID, including this one
Part of
Siu Physicians Surg

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1821716135",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST STE 1700",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIU PHYSICIANS & SURGEONS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIU PHYSICIANS & SURGEONS, INC",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "BURDICK",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "TEAM LEAD, MEDICAL STAFF SERVICES",
        "authorized_official_telephone_number": "217-545-6523"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIU Center for Diabetes and Metabolic Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.