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BENTON COMMUNITY HEALTHCARE
NPI 1780985135
Clinic/Center - Rural Health in Benton, IL

Active since November 16, 2010CLIA 14D1049047 · Waiver
203 BAILEY LN, SUITE 1, BENTON, IL 62812(618) 438-5670(618) 438-5709 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Benton Community Healthcare NPPES

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

BENTON COMMUNITY HEALTHCARE (NPI 1780985135) is a healthcare organization registered as a rural health in Benton, Illinois and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through December 19, 2027 and lists Warren P Ladner, Senior Vp Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1780985135
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSOUTHERN ILLINOIS MEDICAL SERVICES, NFP
Location Address203 BAILEY LN, SUITE 1Benton, IL 62812-1969
Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 457-5200
Phone(618) 438-5670
Fax(618) 438-5709
Organization SubpartYesParent: Southern Illinois Hospital Services
Authorized OfficialWarren P LadnerSenior Vp Chief Financial Officer · (618) 457-5200
Enumeration DateNovember 16, 2010
Last NPPES UpdateJanuary 7, 2025
NPPES CertifiedJanuary 7, 2025
✔ NPI 1780985135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
203 BAILEY LN, Benton, IL 62812
Open in Google Maps ↗

Other Names 1

Doing Business AsBenton Community Healthcare

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 Waiver 14D1049047

Benton Community Healthcare · Benton, IL
Active · expires Dec 19, 2027
CLIA Number14D1049047
Laboratory TypePhysician Office
Certificate Effective DateDecember 20, 2025
Certificate Expiration DateDecember 19, 2027
Laboratory DirectorBrian Harrison
Laboratory Phone(618) 438-5670
Laboratory LocationBenton Community Healthcare203 Bailey Lane, Suite 1, Benton, IL 62812
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CROSSROADS PHYSICIANS CORP
Family Medicine
203 BAILEY LN
BENTON, IL 62812
Franklin County (618) 438-3621
DR. OLUFEYISAYO JOKOTOLA TAIWO M.D.
Obstetrics & Gynecology
203 BAILEY LN
BENTON, IL 62812
Franklin County (618) 899-4000
CHRISTOPHER J OSTROMECKI M.D.
Internal Medicine (Cardiovascular Disease)
203 BAILEY LN
BENTON, IL 62812
Franklin County (618) 899-3900
SOUTHERN ILLINOIS MEDICAL SERVICES, NFP
Clinic/Center (Rural Health)
203 BAILEY LN
BENTON, IL 62812
Franklin County (618) 438-5670
ANTHONY MIKSANEK M.D.
Family Medicine
203 BAILEY LN
BENTON, IL 62812
Franklin County (618) 438-3621

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 Medical Services, Nfp's NPI number?

The NPI number for Southern Illinois Medical Services, Nfp is 1780985135. It was assigned to this organization in the NPPES registry on November 16, 2010. The provider is doing business as Benton Community Healthcare.

Where is Southern Illinois Medical Services, Nfp located?

Southern Illinois Medical Services, Nfp is located at 203 Bailey Ln Suite 1, Benton, IL 62812. The listed phone number is (618) 438-5670.

What is Southern Illinois Medical Services, Nfp's specialty?

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

Does Southern Illinois Medical Services, Nfp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1049047) is associated with this NPI, valid through December 19, 2027. 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 Medical Services, Nfp was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.