Southern Illinois Healthcare Foundation, Inc.
NPI #1740345156 in East Saint Louis, Illinois
Provider Information
- NPI Number
- 1740345156
- Entity Type
- Organization
- Organization Name
- Southern Illinois Healthcare Foundation, Inc.
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Dec 26, 2006
- Last Updated
- Jun 27, 2019
Practice Location
- Address
- 1736 KINGSHIGHWAY
- City
- East Saint Louis
- State
- Illinois
- ZIP Code
- 62204
- Phone
- (618) 874-3120
Authorized Official
- Name
- MR. LARRY MCCULLEY
- Title
- PRESIDENT/CEO
- Phone
- (618) 332-0694
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
| Social Worker - Clinical — Clinical |
| Family Medicine |
| Nurse Practitioner - Family — Family |
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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