Organization · Type 2 NPI

Southern Illinois Healthcare Foundation, Inc.

Federally Qualified Health Center (FQHC) · East St. Louis, IL

NPI number 1770648917 Active

Practice location

2568 N 41st St
East St. Louis, IL 62201-2204

Call (618) 482-4015 Map

Fax (618) 482-4806

Mailing address

8080 State St
East St. Louis, IL 62203-1808

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XNone listed
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed
Nurse Practitioner 363L00000XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1770648917

Southern Illinois Healthcare Foundation, Inc.'s National Provider Identifier is 1770648917, issued on Dec 27, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in East St. Louis, IL. The record was last updated on Jul 29, 2009.