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

Mitchell Wayne Sanders

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1528680162

Mitchell Wayne Sanders is a Physician Assistant in Carbondale, Illinois. Graduated from Southern Illinois University School of Medicine in 2021, 5 years ago. Practices with Southern Illinois Medical Services Nfp, a 332-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Trained at
Southern Illinois University School of Medicine
Licensed in
IL
In the registry since
2020
Specialties on file
3
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Practice location Address checks out

2601 W Main St
Carbondale, IL 62901-1031
Phone: (618) 549-5361
Fax: (618) 351-4878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 405 Rushing Dr, Herrin, IL 62948-3730 — (618) 993-3300
  • 502 W Saint Louis St Ste 4, West Frankfort, IL 62896-1968 — (618) 937-3400

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085008547 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1528680162
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 16, 2020
Last updated in NPPESDecember 9, 2021
Certification dateDecember 9, 2021
Mailing addressPo Box 3988, Carbondale, IL 62902-3988

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Southern Illinois Medical Services Nfp — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Carbondale