Southern Illinois University School of Medicine

Primary specialty

Special HospitalTaxonomy code 284300000X

License

125063931 Issued in IL

Legal business name

SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE

Practice address

701 N 1St St
Room D443
Springfield, IL 62702-3757

Phone

(217) 545-0193

NPI assigned

Jun 26, 2013

Organization subpart

No

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

Authorized official

Name

Andrew Verney, M.D

Title

Program Director

Phone

(217) 545-0193

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1851731640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NORTH FIRST STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "address_2": "ROOM D443",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023757",
            "telephone_number": "217-545-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "VERNEY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "217-545-0193",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "IL",
            "license": "125063931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny L. Sorrell-Wikoff, LMT
• Abbi Sorrells
• South Sixth Medical Associates, LLC
• Alyssa Southard, RBT
• Sheila Marie Southard, D,T.
• Southern View Dental Group
• Danielle Spain, APRN, CNP
• Ann M Sparks, APN, FNP, NP - C
• Sparrow Counseling PLLC
• Sparrow Pediatrics, Inc.

• Special Hospital in Springfield, IL
• Providers in Springfield, IL by specialty
• Special Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.