| Organization Name: | SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC |
| NPI Number: | 1023001377 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREG THOMPSON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 510 Lincoln Dr Herrin |
| State: | IL US |
| Postal Code: | 629486334 |
| Phone Number: | 6189973100 |
| Fax Number: | 6189973616 |
| NPI Enumeration Date: | 08/23/2005 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 7002421 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |