OrganizationActive
Physician Services Corp of Southern Illinois
NPI 1548264237 · Rural Health Clinic/Center · Mount Vernon, IL
Provider details
- NPI number
- 1548264237
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Physician Services Corp of Southern Illinois
- Organization subpart
- Yes
- Authorized official
- Richard Huntington, Vp Financial Development(618) 241-2204
- License
- 0004705 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
21 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
8 Cusumano Professional Plaza Dr
Mount Vernon, IL 62864-6736
Phone: (618) 242-7819
Street-level locationGet directions
Mailing address
413 Main St
Mount Vernon, IL 62864
Other names (DBA / former)
- Doing business as
- St Marys Good Samaritan Medical Group
Registry dates
- Enumerated
- 2005-06-09
- Last updated
- 2009-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.