Healthcare Provider Details

I. General information

NPI: 1568195915
Provider Name (Legal Business Name): ERGIN COSKUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SPRINGFIELD MEMORIAL HOSPITAL 701 N 1ST ST
SPRINGFIELD IL
62781-5109
US

IV. Provider business mailing address

705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US

V. Phone/Fax

Practice location:
  • Phone: 217-788-3000
  • Fax:
Mailing address:
  • Phone: 804-389-1025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number35916
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11022724A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number125.085598
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: