OrganizationActive
Southside Medical Clinic Inc
NPI 1497823314 · Rural Health Clinic/Center · Mount Vernon, IL
Provider details
- NPI number
- 1497823314
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bruce Melvin, Executive Director(618) 242-2745
- License
- 001 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
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
913 South 10th Street
Mount Vernon, IL 62864-5313
Phone: (618) 242-2745
Fax: (618) 242-2766
Street-level locationGet directions
Mailing address
913 South 10th Street
Mount Vernon, IL 62864-5313
Registry dates
- Enumerated
- 2006-11-30
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.