Southern Illinois Regional Wellness Center
NPI #1265588776 in Washington Park, Illinois
Provider Information
- NPI Number
- 1265588776
- Entity Type
- Organization
- Organization Name
- Southern Illinois Regional Wellness Center
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Jan 26, 2007
- Last Updated
- Dec 6, 2011
Practice Location
- Address
- 1835 KINGSHIGHWAY
- City
- Washington Park
- State
- Illinois
- ZIP Code
- 62204-2135
- Phone
- (618) 482-7922
Authorized Official
- Name
- MR. MARK R FREELAND
- Title
- EXECUTIVE DIRECTOR
- Phone
- (618) 874-3120
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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