| Southern Illinois Physicians Group Ltd | |
|
203 E Main St, Greenville, IL 62246-1810 | |
| (618) 692-6700 | |
| (618) 692-6711 |
| Full Name | Southern Illinois Physicians Group Ltd |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 203 E Main St, Greenville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326411927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | David M Thayer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689642951 PECOS PAC ID: 4880680537 Enrollment ID: I20040420001719 |
| Provider Name | Lance Sterling Rahden |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1841563004 PECOS PAC ID: 4284881673 Enrollment ID: I20120820000656 |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Physicians Group Ltd Po Box 997, Edwardsville, IL 62025-0997 Ph: (618) 692-6700 | Southern Illinois Physicians Group Ltd 203 E Main St, Greenville, IL 62246-1810 Ph: (618) 692-6700 |
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