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

Gregory Scott Churchill, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1053390237

Gregory Scott Churchill, PHYSICIANASSISTANT is a Physician Assistant in O Fallon, Illinois. Qualified in 1996, 30 years ago. Practices with Fairview Heights Medical Group SC, a 448-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
30
Licensed in
IL
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

310 N 7 Hills Rd
O Fallon, IL 62269-4111
Phone: (618) 624-6181
Fax: (618) 624-7172
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4500 Memorial Dr Ste 340, Belleville, IL 62226-5360 — (618) 257-5841

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Physician Assistant Taxonomy 363A00000X · Licence 085002702 (IL)

Record details

NPI number1053390237
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJanuary 16, 2006
Last updated in NPPESMarch 25, 2021
Certification dateMarch 25, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Fairview Heights Medical Group Sc — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in O Fallon