Southern Illinois Emergency Medical Services

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

SOUTHERN ILLINOIS EMERGENCY MEDICAL SERVICES

Practice address

1003 W Cherry St
Marion, IL 62959-1913

Phone

(618) 340-1179

Fax

(580) 628-2267

NPI assigned

Dec 12, 2024

Organization subpart

No

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

Authorized official

Name

Brenda Butler

Title

Vice President

Phone

(618) 340-1179

Specialties & licenses 1

Addresses

Other names 1

• SOUTHERN ILLINOIS EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1881401941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N 8TH ST",
            "city": "DUPO",
            "state": "IL",
            "postal_code": "622391514",
            "telephone_number": "618-340-1179",
            "fax_number": "580-628-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W CHERRY ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591913",
            "telephone_number": "618-340-1179",
            "fax_number": "580-628-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS EMERGENCY MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "618-340-1179"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN ILLINOIS EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOUTHERN ILLINOIS EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey Sollers
• Alyssa Jordan Solomon, MS, RD, LDN
• Davood Sooriash, M.D.
• Jason Wayne Sork
• Kathlean Southard, CRSS, MHP
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services
• Southern Illinois Hospital Services

• Land Ambulance in Marion, IL
• Providers in Marion, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.