| Dr Shannon B Rider, MD | |
|
117 E Clark St, Harrisburg, IL 62946-2702 | |
| (618) 252-8625 | |
| (618) 351-4859 |
| Full Name | Dr Shannon B Rider |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 26 Years |
| Location | 117 E Clark St, Harrisburg, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508846429 | NPI | - | NPPES |
| 036105880 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036105880 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hospice Of Southern Ill, Inc | Belleville, IL | Hospice |
| Southern Illinois Hospital Services Dba Herrin Hospital | Herrin, IL | Hospital |
| Harrisburg Medical Center | Harrisburg, IL | Hospital |
| Memorial Hospital Of Carbondale | Carbondale, IL | Hospital |
| Franklin Hospital | Benton, IL | Hospital |
| Ferrell Hospital Community Foundations | Eldorado, IL | Hospital |
| Manor Court Of Carbondale | Carbondale, IL | Nursing home |
| Helia Healthcare Of Energy | Energy, IL | Nursing home |
| Shawnee Senior Living | Herrin, IL | Nursing home |
| Saline Care Nursing & Rehab | Harrisburg, IL | Nursing home |
| Helia Healthcare Of Benton | Benton, IL | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Harrisburg Family Practice Ltd | 2163491564 | 22 |
| Southern Illinois Medical Services Nfp | 3678677390 | 299 |
| Logan Primary Care Service Corp. | 8628967064 | 34 |
| Entity Name | Southern Illinois Medical Services Nfp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shannon B Rider, MD Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200 | Dr Shannon B Rider, MD 117 E Clark St, Harrisburg, IL 62946-2702 Ph: (618) 252-8625 |
Mr. Michael L York, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2340 | |
Mr. Charles E Seten, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540 |