Organization · Type 2 NPI
Southern Illinois Healthcare Foundation, Inc.
Federally Qualified Health Center (FQHC) · Charleston, IL
NPI number
1487070835
Active
Practice location
626 W Lincoln Ave
Charleston, IL 61920-2444
Fax (217) 345-7705
Mailing address
2041 Goose Lake Rd
Sauget, IL 62206-2822
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Clinical Social Worker | 1041C0700X | None listed |
| Dentist | 122300000X | None listed |
| Family Medicine Physician | 207Q00000X | None listed |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
2 other providers at this address
About NPI 1487070835
Southern Illinois Healthcare Foundation, Inc.'s National Provider Identifier is 1487070835, issued on Mar 10, 2014. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Charleston, IL. The record was last updated on Jun 2, 2016.