SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC NPI 1326392747

NPI Information

NPI: 1326392747
Provider Name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC

Doing Business As: MCKINLEY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2166 MADISON AVENUE
GRANITE CITY, IL
ZIP 62040
Phone: (618) 452-3301
Get Directions

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC is a federally qualified health center (fqhc) clinic center in Granite City, IL. SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC NPI is 1326392747. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mckinley Health Center.

The provider's business location address is:

2166 MADISON AVENUE
GRANITE CITY, IL
ZIP 62040
Phone: (618) 452-3301
Fax: (618) 452-3312

The provider's authorized official is Larry W Mcculley .
The authorized official title is Ceo and has the following contact phone number (618) 332-0694.

The CLIA number assigned to this NPI record is 14D0436321 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/7/2012 and was last updated on 11/7/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101Y00000X	Counselor		No
2	1041C0700X	Social Worker	Clinical	No
3	122300000X	Dentist		No
4	207Q00000X	Family Medicine		No
5	207R00000X	Internal Medicine		No
6	207RI0200X	Internal Medicine	Infectious Disease	No
7	207V00000X	Obstetrics & Gynecology		No
8	208000000X	Pediatrics		No
9	2084P0800X	Psychiatry & Neurology	Psychiatry	No
10	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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