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

Southern Spine & Rehab, PLLC

Organization Clinic/Center · NPI 1083254734

Southern Spine & Rehab, PLLC is a Clinic/Center in Marion, Illinois. Works from 2 locations. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1616 W Main St Ste 200
Marion, IL 62959-1146
Phone: (618) 772-2999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1004 Enterprise Dr, Anna, IL 62906 — (618) 772-2999

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1083254734
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kolten Pedigo — Owner · (618) 772-2999
NPI enumeratedJanuary 10, 2020
Last updated in NPPESFebruary 5, 2025
Certification dateFebruary 5, 2025
Mailing address1616 W Main St Ste 200, Marion, IL 62959-1146

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