Southern Illinois Regional Wellness Center
NPI #1336258540 in East Saint Louis, Illinois
Provider Information
- NPI Number
- 1336258540
- Entity Type
- Organization
- Organization Name
- Southern Illinois Regional Wellness Center
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Aug 30, 2006
- Last Updated
- Jul 6, 2016
Practice Location
- Address
- 1736 KINGSHIGHWAY
- City
- East Saint Louis
- State
- Illinois
- ZIP Code
- 62204-2134
- Phone
- (618) 874-3120
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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