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NPI Code Detail

MEDICARE: DR. CHARLES D SIMS M.D.

MEDICARE: DR. CHARLES D SIMS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105721369OTHERILBC/BS OF IL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689765497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES D SIMS M.D.
Provider Business Mailing Address
First Line : 515 E 72ND ST
Second Line :
City : NEW YORK
State : NY
Zip : 10021-4032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 422 W WHITE ST
Second Line :
City : CLINTON
State : IL
Zip : 61727-2272
Country : US
Telephone Number : 217-935-9570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CHARLES D SIMS M.D.” Practice Location

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