| Physician Services Corporation Of Southern Illinois Inc | |
|
1441 W Broadway Centralia IL 62801-0001 | |
| (618) 532-9050 | |
| Not Available |
| Full Name | Physician Services Corporation Of Southern Illinois Inc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1441 W Broadway, Centralia, Illinois |
| Authorized Official Name and Position | Dee Evischi (VP FINANCE MEDICAL GROUP) |
| Authorized Official Contact | 6188991040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Services Corporation Of Southern Illinois Inc 1411 W Broadway Centralia IL 62801-0001 Ph: (618) 532-9050 | Physician Services Corporation Of Southern Illinois Inc 1441 W Broadway Centralia IL 62801-0001 Ph: (618) 532-9050 |
| NPI Number | 1780688671 |
|---|---|
| Provider Enumeration Date | 06/08/2005 |
| Last Update Date | 08/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780688671 | NPI | - | NPPES |
| 1831101807 | Other | IL | NPI PSCSI GRP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 0002642 (Illinois) | Primary |
Tom Martin Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 Ml King Dr, Suite 104, Centralia, IL 62801 Phone: 618-532-6330 Fax: 618-532-7227 | |
Ambulatory Surgery Center Of Centralia, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1045 Martin Luther King Dr, Centralia, IL 62801 Phone: 618-532-3110 Fax: 618-532-3110 | |
Rajendra R Shroff Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 M L King Dr Ste 101, Centralia, IL 62801 Phone: 618-532-5700 | |
Stephen T Ang Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1054 Martin Luther King Dr, Ste 120, Centralia, IL 62801 Phone: 618-532-1688 Fax: 618-436-8081 | |
Dr Shrestha Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1050 M L King Dr, Suite 111, Centralia, IL 62801 Phone: 567-868-4507 Fax: 877-397-7287 | |
Physician Services Corp Of Southern Illinois Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 430 N Pleasant Ave, Centralia, IL 62801 Phone: 618-532-9350 |