SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC NPI 1790455103

NPI Information

NPI: 1790455103
Provider Name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
9649 COLLINSVILLE RD
COLLINSVILLE, IL
ZIP 62234
Phone: (618) 332-0953
Get Directions

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC is a federally qualified health center (fqhc) clinic center in Collinsville, IL. SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC NPI is 1790455103. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9649 COLLINSVILLE RD
COLLINSVILLE, IL
ZIP 62234-876
Phone: (618) 332-0953

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

The enumeration date for this NPI number is 9/16/2021 and was last updated on 9/16/2021.

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	101YP2500X	Counselor	Professional	No
2	1041C0700X	Social Worker	Clinical	No
3	207Q00000X	Family Medicine		No
4	207R00000X	Internal Medicine		No
5	207V00000X	Obstetrics & Gynecology		No
6	208000000X	Pediatrics		No
7	2084P0800X	Psychiatry & Neurology	Psychiatry	No
8	363A00000X	Physician Assistant		No
9	363L00000X	Nurse Practitioner		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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »