| Southern Illinois Psychiatry Llc | |
|
4503 W Deyoung St Ste C-103 Marion IL 62959-0030 | |
| (618) 998-0888 | |
| (618) 993-1808 |
| Full Name | Southern Illinois Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4503 W Deyoung St Ste C-103, Marion, Illinois |
| Authorized Official Name and Position | Naeem A Qureshi (PRESIDENT) |
| Authorized Official Contact | 6189980888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Psychiatry Llc 4503 W Deyoung St Ste C-103 Marion IL 62959-0030 Ph: (618) 998-0888 | Southern Illinois Psychiatry Llc 4503 W Deyoung St Ste C-103 Marion IL 62959-0030 Ph: (618) 998-0888 |
| NPI Number | 1992988299 |
|---|---|
| Provider Enumeration Date | 12/10/2007 |
| Last Update Date | 08/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992988299 | NPI | - | NPPES |
| 036094666 | Medicaid | IL | |
| 207779 | Other | IL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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