Board of Trustees of Southern Illinois University
NPI #1518343722 in Springfield, Illinois
Provider Information
- NPI Number
- 1518343722
- Entity Type
- Organization
- Organization Name
- Board of Trustees of Southern Illinois University
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Aug 11, 2015
- Last Updated
- Aug 13, 2015
Practice Location
- Address
- 5220 S 6TH STREET RD
- Address 2
- SUITE 1500
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62703-5735
- Phone
- (217) 545-8000
Authorized Official
- Name
- IRIS WESLEY
- Title
- CEO/FQHC DIRECTOR
- Phone
- (217) 545-8000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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