OrganizationActive
Southern Illinois Center for Health
NPI 1104988971 · Family Medicine Physician · Waterloo, IL
Provider details
- NPI number
- 1104988971
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Judy Rebholz, Office Manager(618) 939-3939
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
509 Hamacher St
Waterloo, IL 62298-1592
Phone: (618) 939-3939
Fax: (618) 939-3941
Street-level locationGet directions
Mailing address
509 Hamacher St
Waterloo, IL 62298-1592
Registry dates
- Enumerated
- 2006-12-15
- Last updated
- 2008-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.