Southern Illinois Healthcare Foundation INC
NPI #1790548782 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1790548782
- Entity Type
- Organization
- Organization Name
- Southern Illinois Healthcare Foundation INC
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Feb 1, 2024
- Last Updated
- Feb 29, 2024
Practice Location
- Address
- 4230 S STATE ROUTE 159
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62034-3201
- Phone
- (618) 332-0694
Authorized Official
- Name
- LARRY MCCULLEY
- Title
- PRESIDENT/CEO
- Phone
- (618) 332-0694
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
| Physician Assistant |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
Additional Practice Locations
4230 IL-159
Glen Carbon, IL, 62034-3201
(618) 391-9443
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