1. Home
  2. Directory
  3. Illinois
  4. Carbondale
  5. Internal Medicine
  6. NPI Profile

SOUTHERN ILLINOIS GI SPECIALISTS LLC
NPI 1093775405
Internal Medicine - Gastroenterology in Carbondale, IL

Active since March 28, 2006CLIA 14D2074735 · Accreditation
1100 W DIANN LN, CARBONDALE, IL 62901(618) 549-8006(618) 549-8434 Get Directions Write a Review

NPPES record last updated: August 12, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Southern Illinois Gi Specialists Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN ILLINOIS GI SPECIALISTS LLC (NPI 1093775405) is a healthcare organization registered as a gastroenterology in Carbondale, Illinois and active in the NPI registry since March 2006. The organization holds an CLIA Accreditation certificate valid through April 19, 2028 and lists Zahoor A Makhdoom, Md Owner, as its authorized official.

NPPES Registry Identity

NPI1093775405
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameSOUTHERN ILLINOIS GI SPECIALISTS LLC
Location Address1100 W DIANN LNCarbondale, IL 62901-5339
Mailing AddressPo Box 365Carbondale, IL 62903-0365 · (618) 476-9399 · Fax (618) 476-9547
Phone(618) 549-8006
Fax(618) 549-8434
Organization SubpartNo
Authorized OfficialZahoor A MakhdoomMd Owner · (618) 549-8006
Enumeration DateMarch 28, 2006
Last NPPES UpdateAugust 12, 2008
✔ NPI 1093775405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in IL · 036094155
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1100 W DIANN LN, Carbondale, IL 62901
Open in Google Maps ↗

Other Identifiers 7

Medicaid036094155IL
Medicare PIN210478IL
Other03926864IL · Bcbs Il
Other063398Health Alliance Hmo
Other435384Healthlink
Medicare UPING55154
Medicare PINDG1904

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Illinois Gi Specialists Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Southern Illinois Gi Specialists LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Kaile Eggemeyer
Nurse Practitioner
NPI 1588264493
1100 W DIANN LN
Carbondale, IL 62901
(618) 549-8006
✔ PECOS✔ Accepts MedicareSame address
Zahoor Makhdoom, MD
Gastroenterology
NPI 1982667309
1100 W DIANN LN
Carbondale, IL 62901
(618) 549-8006
✔ PECOS✔ Accepts MedicareSame address
Megan Mcclellan, APN, FNP-L
Nurse Practitioner
NPI 1740795194
1100 W DIANN LN.
Carbondale, IL 62901
(618) 549-8006
✔ PECOS✔ Accepts MedicareSame address
Atif Raja
Pathology
NPI 1477083806
3333 W DEYOUNG ST
Marion, IL 62959
(210) 617-4445
✔ PECOS✔ Accepts Medicare14 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 14D2074735

Southern Illinois G I Specialists L L C · Carbondale, IL
Active · expires Apr 19, 2028
CLIA Number14D2074735
Laboratory TypePhysician Office
Certificate Effective DateApril 20, 2026
Certificate Expiration DateApril 19, 2028
Laboratory DirectorDr. Atif A. Raja
Laboratory Phone(618) 549-8006
Laboratory LocationSouthern Illinois G I Specialists L L C1100 West Diann Lane, Carbondale, IL 62901
CLIA data matches this NPI record on: Address Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Illinois Gi Specialists LLC's NPI number?

The NPI number for Southern Illinois Gi Specialists LLC is 1093775405. It was assigned to this organization in the NPPES registry on March 28, 2006.

Where is Southern Illinois Gi Specialists LLC located?

Southern Illinois Gi Specialists LLC is located at 1100 W Diann Ln, Carbondale, IL 62901. The listed phone number is (618) 549-8006.

What is Southern Illinois Gi Specialists LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Southern Illinois Gi Specialists LLC enrolled in Medicare?

Yes. Southern Illinois Gi Specialists LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern Illinois Gi Specialists LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Southern Illinois Gi Specialists LLC, in Gastroenterology, Nurse Practitioner and Pathology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Southern Illinois Gi Specialists LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 14D2074735) is associated with this NPI, valid through April 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Illinois Gi Specialists LLC was last updated on August 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.