SOUTHERN ILLINOIS FAMILY MEDICINE CORPORATION
NPI 1629086806
Family Medicine in Glen Carbon, IL
About Southern Illinois Family Medicine Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN ILLINOIS FAMILY MEDICINE CORPORATION (NPI 1629086806) is a healthcare organization registered as a family medicine in Glen Carbon, Illinois and active in the NPI registry since August 2006. The organization lists Jim Hong, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 Family Medicine Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Illinois Family Medicine Corporation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Family Medicine Corporation's NPI number?
The NPI number for Southern Illinois Family Medicine Corporation is 1629086806. It was assigned to this organization in the NPPES registry on August 4, 2006.
Where is Southern Illinois Family Medicine Corporation located?
Southern Illinois Family Medicine Corporation is located at 104 Magnolia Dr Ste A, Glen Carbon, IL 62034. The listed phone number is (618) 288-9466.
What is Southern Illinois Family Medicine Corporation's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Southern Illinois Family Medicine Corporation enrolled in Medicare?
Yes. Southern Illinois Family Medicine Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Illinois Family Medicine Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Southern Illinois Family Medicine Corporation. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Southern Illinois Family Medicine Corporation was last updated on February 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Southern Illinois Family Medicine Corporation · NPI 1629086806
Family Medicine organization in Glen Carbon, Illinois. Organization record, active in the CMS NPPES registry since August 4, 2006.
## Identity
- **NPI:** 1629086806 (Entity type: Organization)
- **Enumerated:** August 4, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Jim Hong, OWNER
## Practice location
- **Address:** 104 MAGNOLIA DR STE A, Glen Carbon, IL 62034-1595
- **Phone:** (618) 288-9466
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 1, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1629086806) · Data from the CMS NPPES public registry.