ST. MARY'S GOOD SAMARITAN MEDICAL GROUP
NPI 1154725976
Non-Pharmacy Dispensing Site in Mount Vernon, IL

Q: What is Physician Services Corporation Of Southern Illinois Inc's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Active since October 22, 2014

602 S 42ND ST STE B, MOUNT VERNON, IL 62864(618) 899-3278(618) 242-1853 Get Directions Write a Review

NPPES record last updated: October 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About St. Mary's Good Samaritan Medical Group NPPES

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

ST. MARY'S GOOD SAMARITAN MEDICAL GROUP (NPI 1154725976) is a healthcare organization registered as a non-pharmacy dispensing site in Mount Vernon, Illinois and active in the NPI registry since October 2014. The organization lists Deland Evischi, Vp Finance Smgsmg, as its authorized official.

NPPES Registry Identity

NPI1154725976

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NamePHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC

Location Address602 S 42ND ST STE BMount Vernon, IL 62864-6264

Mailing Address602 S 42nd St Ste BMount Vernon, IL 62864-6264 · (618) 899-3278 · Fax (618) 242-1853

Phone(618) 899-3278

Fax(618) 242-1853

Organization SubpartNo

Authorized OfficialDeland EvischiVp Finance Smgsmg · (618) 899-1040

Enumeration DateOctober 22, 2014

✔ NPI 1154725976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

602 S 42ND ST STE B, Mount Vernon, IL 62864

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Other Names 1

Doing Business AsSt. Mary's Good Samaritan Medical Group

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 Physician Services Corporation Of Southern Illinois Inc's NPI number?

The NPI number for Physician Services Corporation Of Southern Illinois Inc is 1154725976. It was assigned to this organization in the NPPES registry on October 22, 2014. The provider is doing business as St. Mary's Good Samaritan Medical Group.

Where is Physician Services Corporation Of Southern Illinois Inc located?

Physician Services Corporation Of Southern Illinois Inc is located at 602 S 42nd St Ste B, Mount Vernon, IL 62864. The listed phone number is (618) 899-3278.

What is Physician Services Corporation Of Southern Illinois Inc's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Physician Services Corporation Of Southern Illinois Inc was last updated on October 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.