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

Southern Illinois Healthcare Foundation, Inc

Organization Family Medicine Physician · NPI 1770648917

Southern Illinois Healthcare Foundation, Inc is a Family Medicine Physician in East Saint Louis, Illinois. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2568 N 41st St
East Saint Louis, IL 62201-2204
Phone: (618) 482-4015
Fax: (618) 482-4806
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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
Family Medicine Physician Taxonomy 207Q00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1770648917
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larry McCulley — President · (618) 332-0783
Other names Fairmont City Health Center
NPI enumeratedDecember 27, 2006
Last updated in NPPESJuly 29, 2009
Mailing address8080 State St, East Saint Louis, IL 62203-1808

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