Southern Illinois Healthcare Foundation, Inc.
NPI #1306902945 in East Saint Louis, Illinois
Provider Information
- NPI Number
- 1306902945
- Entity Type
- Organization
- Organization Name
- Southern Illinois Healthcare Foundation, Inc.
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Dec 28, 2006
- Last Updated
- Oct 30, 2008
Practice Location
- Address
- 6010 BOND AVE
- City
- East Saint Louis
- State
- Illinois
- ZIP Code
- 62207-2328
- Phone
- (618) 337-8153
Authorized Official
- Name
- MR. LARRY MCCULLEY
- Title
- CHIEF OPERATING OFFICER
- Phone
- (618) 332-0694
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Internal Medicine |
| Internal Medicine - Cardiovascular Disease — Cardiovascular Disease |
| Otolaryngology |
| Physician Assistant |
| Nurse Practitioner |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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