BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY is a federally qualified health center (fqhc) clinic center in Decatur, IL. BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY NPI is 1407376338. The provider is registered as an organization entity type.
The provider Other Name Is Siu Center For Family Medicine - Decatur.
The provider's business location address is:
102 W KENWOOD AVE
DECATUR, IL
ZIP 62526-368
Phone: (217) 872-3800
Fax: (217) 872-0849
The provider's authorized official is Iris Wesley .
The authorized official title is Chief Executive Officer and has the following contact phone number (217) 545-7876.
The CLIA number assigned to this NPI record is 14D0435205 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 6/21/2017 and was last updated on 6/21/2017.