Southern Illinois Healthcare Foundation, Inc.
NPI #1770648917 in East Saint Louis, Illinois
Provider Information
- NPI Number
- 1770648917
- Entity Type
- Organization
- Organization Name
- Southern Illinois Healthcare Foundation, Inc.
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Dec 27, 2006
- Last Updated
- Jul 29, 2009
Practice Location
- Address
- 2568 N 41ST ST
- City
- East Saint Louis
- State
- Illinois
- ZIP Code
- 62201-2204
- Phone
- (618) 482-4015
Authorized Official
- Name
- MR. LARRY MCCULLEY
- Title
- PRESIDENT
- Phone
- (618) 332-0783
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Nurse Practitioner |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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