BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY NPI 1497002182

NPI Information

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY is a federally qualified health center (fqhc) clinic center in Springfield, IL. BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY NPI is 1497002182. The provider is registered as an organization entity type.
The provider Is Doing Business As Siu Center For Family Medicine.

The provider's business location address is:

520 N 4TH ST
SPRINGFIELD, IL
ZIP 62702-238
Phone: (217) 545-8000
Fax: (217) 747-1351

The provider's authorized official is Linda A Toth .
The authorized official title is Authorizing Official and has the following contact phone number (217) 545-8000.

The enumeration date for this NPI number is 8/13/2012 and was last updated on 8/13/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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