Board of Trustees of Southern Illinois University
NPI #1649628009 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1649628009
- Entity Type
- Organization
- Organization Name
- Board of Trustees of Southern Illinois University
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- May 26, 2016
- Last Updated
- May 26, 2016
Practice Location
- Address
- 345 W STATE ST
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-1879
- Phone
- (217) 245-5111
Authorized Official
- Name
- IRIS WESLEY
- Title
- CEO
- Phone
- (217) 545-8000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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