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

St Mary's Hospital, Centralia, Illinois

Organization Anesthesiology Physician · NPI 1477097871

St Mary's Hospital, Centralia, Illinois is an Anesthesiology Physician in Centralia, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016
Specialties on file
2

Practice location Address checks out

400 N Pleasant Ave
Centralia, IL 62801-3056
Phone: (618) 436-6056
Fax: (618) 532-9365
Show map & directions

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

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 0002642 (IL)
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X · Licence 0002642 (IL)

Record details

NPI number1477097871
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tim Buller — Regional Cfo · (314) 989-2492
Other names Ssm Health St. Mary'S Hospital - Centralia
NPI enumeratedDecember 5, 2016
Last updated in NPPESMarch 26, 2018
Mailing address1145 Corporate Lake Dr, Saint Louis, MO 63132-2907

Other providers in Centralia