| Organization Name: | SOUTHERN ILLINOIS HEALTHCARE |
| NPI Number: | 1528126257 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY KAY WIGGS (ORTHOPEDIC PROGRAM COORDINATOR) |
| Mailing Address: | 201 S 14th Street Herrin |
| State: | IL US |
| Postal Code: | 62948 |
| Phone Number: | 6189422171 |
| Fax Number: | 6183514943 |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 07/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070009719 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |