Healthcare Provider Details

I. General information

NPI: 1447175724
Provider Name (Legal Business Name): SOUTHERN ILLINOIS HOSPITAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E SHAWNEE DR
MURPHYSBORO IL
62966-7048
US

IV. Provider business mailing address

1239 E MAIN ST
CARBONDALE IL
62901-3175
US

V. Phone/Fax

Practice location:
  • Phone: 618-684-3156
  • Fax: 618-529-0565
Mailing address:
  • Phone: 618-457-5200
  • Fax: 618-529-0565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANNON S HARTKE
Title or Position: CORPORATE DIRECTOR OF PFS
Credential:
Phone: 618-457-5200