Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Board of Trustees of Southern Illinois University

Organization Federally Qualified Health Center (FQHC) · NPI 1770259764

Board of Trustees of Southern Illinois University is a Federally Qualified Health Center (FQHC) in Springfield, Illinois. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1600 E Clear Lake Ave Ste 120
Springfield, IL 62703-1172
Phone: (217) 545-8000
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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
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1770259764
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBoard of Trustees of Southern Illinois University
Authorized official Iris Wesley — Ceo · (217) 545-8000
Other names Siu Center For Family Medicine - Gim Salvation Army
NPI enumeratedAugust 19, 2021
Last updated in NPPESJanuary 9, 2025
Certification dateJanuary 9, 2025
Mailing addressPo Box 19639, Springfield, IL 62794-9639

Other providers in Springfield