Organization · Type 2 NPI

Southern Illinois University

Clinic/Center · East St. Louis, IL

NPI number 1306273776 Active

Practice location

601 James R Thompson Blvd, Building D, Suite 2015
East St. Louis, IL 62201-1129

Call (618) 482-6959 Map

Fax (618) 482-8311

Specialties and licenses

TaxonomyCodeLicense
Clinic/Center Primary 261Q00000XNone listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

9 other providers at this address

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About NPI 1306273776

Southern Illinois University's National Provider Identifier is 1306273776, issued on Oct 1, 2013. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in East St. Louis, IL. The record was last updated on Oct 1, 2013.