Organization · Type 2 NPI
Southern Illinois Healthcare Foundation Inc
Federally Qualified Health Center (FQHC) · Roxana, IL
NPI number
1750104162
Active
Practice location
401 Chaffer Ave
Roxana, IL 62084-1125
Mailing address
2041 Goose Lake Rd
Sauget, IL 62206-2822
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | None listed |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
4 other providers at this address
- Roxana Cusd No 1Local Education Agency (LEA) Roxana, IL NPI 1376595918
- Leah M. Brueckner, ATCAthletic Trainer Roxana, IL NPI 1801504923
- Nichole Rae Hanneken Ontis, M.S., CCC-SLPSpeech-Language Pathologist Roxana, IL NPI 1255835567
- Sara Anne KreutztragerSpeech-Language Pathologist Roxana, IL NPI 1477432623
About NPI 1750104162
Southern Illinois Healthcare Foundation Inc's National Provider Identifier is 1750104162, issued on Nov 4, 2024. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Roxana, IL. The record was last updated on Nov 4, 2024.