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

Southern Illinois Neuropsychology LLC

Organization Clinical Neuropsychologist · NPI 1861909509

Southern Illinois Neuropsychology LLC is a Clinical Neuropsychologist in Edwardsville, Illinois. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

60 S State Route 157
Edwardsville, IL 62025
Phone: (618) 391-4021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 071009269 (IL)

Record details

NPI number1861909509
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phillip Ruppert — Owner · (618) 391-4021
NPI enumeratedJanuary 3, 2018
Last updated in NPPESFebruary 10, 2022
Certification dateFebruary 10, 2022
Mailing address1 Oak Dr Unit 352, Maryville, IL 62062-7026