Organization · Type 2 NPI

Board of Trustees of Southern Illinois University

Federally Qualified Health Center (FQHC) · Quincy, IL

NPI number 1376921924 Active

Practice location

612 N 11th St
Quincy, IL 62301-2662

Call (217) 224-9484 Map

Fax (217) 224-7950

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 1376921924

Board of Trustees of Southern Illinois University's National Provider Identifier is 1376921924, issued on May 15, 2015. 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.