Southern Illinois Healthcare Foundation, Inc.
NPI #1386825412 in Pontoon Beach, Illinois
Provider Information
- NPI Number
- 1386825412
- Entity Type
- Organization
- Organization Name
- Southern Illinois Healthcare Foundation, Inc.
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Nov 16, 2007
- Last Updated
- Nov 16, 2007
Practice Location
- Address
- 3924 OAKMONT DR
- City
- Pontoon Beach
- State
- Illinois
- ZIP Code
- 62040-4395
- Phone
- (618) 397-3303
Authorized Official
- Name
- MR. LARRY MCCULLEY
- Title
- COO
- Phone
- (618) 332-0694
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Psychiatry & Neurology - Psychiatry — Psychiatry |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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