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

Southern Illinois Treatment Center, LLC

Organization Addiction (Substance Use Disorder) Counselor · NPI 1841858404

Southern Illinois Treatment Center, LLC is an Addiction (Substance Use Disorder) Counselor in Wood River, Illinois. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

304 Wesley Dr Ste 302306
Wood River, IL 62095-2266
Phone: (618) 258-7592
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Methadone Clinic Taxonomy 261QM2800X

Record details

NPI number1841858404
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Jarvie — Vp, Treasurer · (214) 379-3300
Other names Medmark Treatment Centers Wood River
NPI enumeratedMay 30, 2019
Last updated in NPPESJuly 29, 2024
Certification dateJuly 29, 2024
Mailing address1720 Lakepointe Dr Ste 117, Lewisville, TX 75057-6425

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