| Southern Illinois Gi Specialists Llc | |
|
1100 W Diann Ln Carbondale IL 62901-5339 | |
| (618) 549-8006 | |
| (618) 549-8434 |
| Full Name | Southern Illinois Gi Specialists Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1100 W Diann Ln, Carbondale, Illinois |
| Authorized Official Name and Position | Zahoor A Makhdoom (MD OWNER) |
| Authorized Official Contact | 6185498006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Gi Specialists Llc Po Box 365 Carbondale IL 62903-0365 Ph: (618) 476-9399 | Southern Illinois Gi Specialists Llc 1100 W Diann Ln Carbondale IL 62901-5339 Ph: (618) 549-8006 |
| NPI Number | 1093775405 |
|---|---|
| Provider Enumeration Date | 03/28/2006 |
| Last Update Date | 08/12/2008 |
| Medicare PECOS PAC ID | 1658337456 |
|---|---|
| Medicare Enrollment ID | O20041203000280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093775405 | NPI | - | NPPES |
| 063398 | Other | HEALTH ALLIANCE HMO | |
| 036094155 | Medicaid | IL | |
| 03926864 | Other | IL | BCBS IL |
| 435384 | Other | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 036094155 (Illinois) | Primary |
| Provider Name | Moses O Adeyanju |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1306820121 PECOS PAC ID: 7012995137 Enrollment ID: I20040713001297 |
| Provider Name | Ellen M Chapman Pogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114996642 PECOS PAC ID: 6002879970 Enrollment ID: I20041111000105 |
| Provider Name | Zahoor Ahmed Makhdoom |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982667309 PECOS PAC ID: 0840256673 Enrollment ID: I20041216000555 |
| Provider Name | Douglas C Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033364674 PECOS PAC ID: 5496941353 Enrollment ID: I20101118000510 |
| Provider Name | Alisa Dearmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427456961 PECOS PAC ID: 7315265352 Enrollment ID: I20150423000612 |
| Provider Name | Andrea S Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063800944 PECOS PAC ID: 4284941063 Enrollment ID: I20150910001735 |
| Provider Name | Tashia I Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467808584 PECOS PAC ID: 7315239662 Enrollment ID: I20160707001592 |
| Provider Name | Ariele N Loiacono |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407366123 PECOS PAC ID: 7517228166 Enrollment ID: I20180223000164 |
| Provider Name | Megan M Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740795194 PECOS PAC ID: 1658632153 Enrollment ID: I20180226000506 |
| Provider Name | Amanda Wilderman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659915171 PECOS PAC ID: 2668896390 Enrollment ID: I20200728000888 |
| Provider Name | Amy J Glasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689241309 PECOS PAC ID: 0941692792 Enrollment ID: I20220127002982 |
Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 374 East Grand Avenue, Mail Code 674d, Carbondale, IL 62901 Phone: 618-453-3311 Fax: 618-453-4449 | |
The Carbondale Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-457-5200 Fax: 618-549-5128 | |
Community Health & Emergency Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 Cedar Ct, Carbondale, IL 62901 Phone: 618-351-1213 Fax: 618-351-1905 | |
Carbondale Community High Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Giant City Rd, Carbondale, IL 62902 Phone: 618-457-4722 Fax: 618-457-3353 | |
Southern Illinois Medical Services, Nfp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-549-5361 Fax: 618-351-4878 | |
Brown's Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 W Jackson St, Carbondale, IL 62901 Phone: 618-351-9559 |