Board of Trustees of Southern Illinois University

NPI #1366129843 in Springfield, Illinois

Provider Information

NPI Number: 1366129843
Entity Type: Organization
Organization Name: Board of Trustees of Southern Illinois University
Subpart: Yes (part of a larger organization)
Parent Organization: BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Primary Specialty: Clinic/Center
Enumeration Date: Jun 28, 2023
Last Updated: Jun 28, 2023

Practice Location

Address: 401 N WALNUT ST
City: Springfield
State: Illinois
ZIP Code: 62702-5033
Phone: (217) 545-7815

Authorized Official

Name: IRIS WESLEY
Title: CEO
Phone: (217) 757-8137

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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