Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Physician Services Corp of Southern Illinois

Organization Obstetrics & Gynecology Physician · NPI 1740421536

Physician Services Corp of Southern Illinois is an Obstetrics & Gynecology Physician in Centralia, Illinois. Licensed in Illinois. Registered with an NPI since 2009.

Licensed in
IL
In the registry since
2009
Specialties on file
2
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

430 N Pleasant Ave
Centralia, IL 62801-3006
Phone: (618) 532-9350
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 036116791 (IL)
Rural Health Clinic/Center Taxonomy 261QR1300X · Licence 002642 (IL)

Record details

NPI number1740421536
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationPhysician Services Corp of Southern Illinois
Authorized official Tammy Simonton — Mng · (618) 436-6267
Other names St Marys Good Samaritan Medical Group
NPI enumeratedMarch 9, 2009
Last updated in NPPESMarch 12, 2009
Mailing address430 N Pleasant Ave, Centralia, IL 62801-3006