Board of Trustees of Southern Illinois University
Board of Trustees of Southern Illinois University is a Federally Qualified Health Center (FQHC) in Decatur, Illinois. Licensed in Illinois. Registered with an NPI since 2017.
- Licensed in
- IL
- In the registry since
- 2017
- Specialties on file
- 2
Practice location Address checks out
102 W Kenwood AveDecatur, IL 62526-4368
Phone: (217) 872-3800
Fax: (217) 872-0849
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X (IL) |
|---|---|
| Primary Care Clinic/Center | Taxonomy 261QP2300X |
Record details
| NPI number | 1407376338 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Board of Trustees of Southern Illinois University |
| Authorized official | Iris Wesley — Chief Executive Officer · (217) 545-7876 |
| Other names | Siu Center For Family Medicine - Decatur |
| NPI enumerated | June 21, 2017 |
| Last updated in NPPES | January 9, 2025 |
| Certification date | January 9, 2025 |
| Mailing address | Po Box 19639, Springfield, IL 62794-9639 |
Other providers in Decatur
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-
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-
Community Health Improvement Center
320 E Central Ave, Decatur, IL 62521-4665 · (217) 877-9117
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Community Health Improvement Center
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