Board of Trustees of Southern Illinois University
Board of Trustees of Southern Illinois University is a Federally Qualified Health Center (FQHC) in Jacksonville, Illinois. Licensed in Illinois. Registered with an NPI since 2016.
- Licensed in
- IL
- In the registry since
- 2016
Practice location Address checks out
345 W State StJacksonville, IL 62650-1879
Phone: (217) 245-5111
Fax: (217) 243-4773
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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) |
|---|
Record details
| NPI number | 1649628009 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Iris Wesley — Ceo · (217) 545-8000 |
| Other names | Siu Center For Family Medicine-Jacksonville |
| NPI enumerated | May 26, 2016 |
| Last updated in NPPES | May 26, 2016 |
| Mailing address | 520 N 4th St, Po Box 19671, Springfield, IL 62702-5238 |
Other providers in Jacksonville
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Board of Trustees of Southern Illinois University
425 E State St Ste 100, Jacksonville, IL 62650-2125 · (217) 408-1195