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

Southern Illinois Family Medicine Corporation

Organization Family Medicine Physician · NPI 1629086806

Southern Illinois Family Medicine Corporation is a Family Medicine Physician in Glen Carbon, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006

Practice location Address checks out

104 Magnolia Dr Ste A
Glen Carbon, IL 62034-1595
Phone: (618) 288-9466
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036114185 (IL)

Record details

NPI number1629086806
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jim Hong — Owner · (618) 288-9466
NPI enumeratedAugust 4, 2006
Last updated in NPPESFebruary 1, 2018
Mailing address104 Magnolia Dr Ste A, Glen Carbon, IL 62034-1595

Other providers in Glen Carbon