Physician Compare National (NPI:1629203708)

HEALTHCARE PROVIDER: MICHAEL PATRICK LAWLER MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1629203708
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466508601
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090914000288
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LAWLER
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SOUTHERN ILLINOIS MEDICAL SERVICES, NFP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3678677390
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	343
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2601 W MAIN ST
	Group Practice or individual's line 1 address
City	CARBONDALE
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	629011031
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6185495361
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHERN ILLINOIS HOSPITAL SERVICES DBA HERRIN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140184
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HEARTLAND REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140164
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEMORIAL HOSPITAL OF CARBONDALE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140046
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SSM HEALTH - GOOD SAMARITAN HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y