SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC. NPI 1689739062

NPI Information

  • NPI: 1689739062
  • Provider Name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: CAHOKIA SCHOOL BASED CENTER
  • Address: 800 RANGE LN
    CAHOKIA, IL
    ZIP 62206
  • Phone: (618) 337-3117

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NPI Details

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. is a federally qualified health center (fqhc) clinic center in Cahokia, IL. SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. NPI is 1689739062. The provider is registered as an organization entity type.
The provider Is Doing Business As Cahokia School Based Center.

The provider's business location address is:

800 RANGE LN
CAHOKIA, IL
ZIP 62206-022
Phone: (618) 337-3117
Fax: (618) 337-3122

The provider's authorized official is Larry Mcculley .
The authorized official title is Chief Operating Officer and has the following contact phone number (618) 332-0783.

The enumeration date for this NPI number is 12/26/2006 and was last updated on 8/22/2020.

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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes
2363LS0200XNurse PractitionerSchoolX

What is NPI?

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This page was last updated on: 3/30/2025

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