Organization · Type 2 NPI

Board of Trustees of Southern Illinois University

Federally Qualified Health Center (FQHC) · Springfield, IL

NPI number 1184494619 Active

Practice location

3220 Atlanta St Ste 100
Springfield, IL 62707-8801

Call (217) 545-4968 Map

Fax (217) 545-4444

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...

3 other providers at this address

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About NPI 1184494619

Board of Trustees of Southern Illinois University's National Provider Identifier is 1184494619, issued on Jan 5, 2024. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Springfield, IL. The record was last updated on Jan 9, 2025.