Organization · Type 2 NPI

Board of Trustees of Southern Illinois University

Federally Qualified Health Center (FQHC) · Quincy, IL

NPI number 1003324260 Active

Practice location

4409 Maine St Ste 100
Quincy, IL 62305-5849

Call (217) 919-9139 Map

Fax (217) 223-0461

Mailing address

PO Box 19639
Springfield, IL 62794-9639

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed
Primary Care Clinic/Center 261QP2300XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1003324260

Board of Trustees of Southern Illinois University's National Provider Identifier is 1003324260, issued on Jan 22, 2018. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Quincy, IL. The record was last updated on Jan 9, 2025.