Board of Trustees of Southern Illinois University

NPI #1679188437 in Springfield, Illinois

Provider Information

NPI Number
1679188437
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 - Federally Qualified Health Center (FQHC)
Enumeration Date
Sep 9, 2020
Last Updated
Jan 9, 2025

Practice Location

Address
751 N RUTLEDGE ST STE 1100
ZIP Code
62702-4968
Phone
(217) 545-8000

Authorized Official

Name
IRIS WESLEY
Title
CEO
Phone
(217) 545-8000

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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