BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY NPI 1184494619

NPI Information

NPI: 1184494619
Provider Name: BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3220 ATLANTA ST
SPRINGFIELD, IL
ZIP 62707
Phone: (217) 545-8000
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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 1184494619. The provider is registered as an organization entity type.

The provider's business location address is:

3220 ATLANTA ST
SPRINGFIELD, IL
ZIP 62707-801
Phone: (217) 545-8000

The provider's authorized official is Iris Wesley .
The authorized official title is Ceo and has the following contact phone number (217) 757-8137.

The enumeration date for this NPI number is 1/5/2024 and was last updated on 1/5/2024.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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