Board of Trustees of Southern Illinois University
Board of Trustees of Southern Illinois University is a Federally Qualified Health Center (FQHC) in Jacksonville, Illinois. Registered with an NPI since 2022.
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
425 E State St Ste 100Jacksonville, IL 62650-2125
Phone: (217) 408-1195
Fax: (217) 408-1231
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X |
|---|---|
| Primary Care Clinic/Center | Taxonomy 261QP2300X |
Record details
| NPI number | 1598412447 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Board of Trustees of Southern Illinois University |
| Authorized official | Iris Wesley — Ceo · (217) 545-8000 |
| Other names | Siu Center For Family Medicine-Jacksonville; Siu Center For Family Medicine-Jacksonville |
| NPI enumerated | March 9, 2022 |
| Last updated in NPPES | January 9, 2025 |
| Certification date | January 9, 2025 |
| Mailing address | Po Box 19639, Springfield, IL 62794-9639 |
Other providers in Jacksonville
-
Board of Trustees of Southern Illinois University
345 W State St, Jacksonville, IL 62650-1879 · (217) 245-5111