Provider Demographics
NPI:1386734127
Name:INTERNAL MEDICINE SPECIALISTS LTD
Entity type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EARNSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-465-5414
Mailing Address - Street 1:103B SOUTHPOINTE
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3651
Mailing Address - Country:US
Mailing Address - Phone:618-692-9640
Mailing Address - Fax:618-692-9643
Practice Address - Street 1:815 E 5TH ST
Practice Address - Street 2:SUITE 408
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6471
Practice Address - Country:US
Practice Address - Phone:618-465-5414
Practice Address - Fax:618-465-9865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty