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SOUTHSIDE MEDICAL CLINIC INC
NPI 1497823314
Clinic/Center - Rural Health in Mount Vernon, IL

Active since November 30, 2006
913 SOUTH 10TH STREET, MOUNT VERNON, IL 62864(618) 242-2745(618) 242-2766 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Southside Medical Clinic Inc NPPES

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

SOUTHSIDE MEDICAL CLINIC INC (NPI 1497823314) is a healthcare organization registered as a rural health in Mount Vernon, Illinois and active in the NPI registry since November 2006. The organization lists Bruce Wayne Melvin, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1497823314
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSOUTHSIDE MEDICAL CLINIC INC
Location Address913 SOUTH 10TH STREETMount Vernon, IL 62864-5313
Mailing Address913 South 10th StreetMount Vernon, IL 62864-5313 · (618) 242-2745 · Fax (618) 242-2766
Phone(618) 242-2745
Fax(618) 242-2766
Organization SubpartNo
Authorized OfficialBruce Wayne MelvinExecutive Director · (618) 242-2745
Enumeration DateNovember 30, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1497823314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in IL · 001
913 SOUTH 10TH STREET, Mount Vernon, IL 62864
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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 Southside Medical Clinic Inc's NPI number?

The NPI number for Southside Medical Clinic Inc is 1497823314. It was assigned to this organization in the NPPES registry on November 30, 2006.

Where is Southside Medical Clinic Inc located?

Southside Medical Clinic Inc is located at 913 South 10th Street, Mount Vernon, IL 62864. The listed phone number is (618) 242-2745.

What is Southside Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Southside Medical Clinic Inc was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.