SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC. NPI 1255880647

NPI Information

NPI: 1255880647
Provider Name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

Doing Business As: ILLINI FAMILY MEDICINE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2900 FRANK SCOTT PKWY W
SUITE 980
BELLEVILLE, IL
ZIP 62223
Phone: (618) 397-3303
Get Directions

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. is a federally qualified health center (fqhc) clinic center in Belleville, IL. SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. NPI is 1255880647. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Illini Family Medicine.

The provider's business location address is:

2900 FRANK SCOTT PKWY W
SUITE 980
BELLEVILLE, IL
ZIP 62223-000
Phone: (618) 397-3303

The provider's authorized official is Larry Mcculley .
The authorized official title is Ceo and has the following contact phone number (618) 332-0694.

The CLIA number assigned to this NPI record is 14D0698997 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2016 and was last updated on 9/26/2016.

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	207Q00000X	Family Medicine			ILLINOIS	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		ILLINOIS	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: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »