BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

QUINCY, IL
NPI1083121537
Other NameSIU CENTER FOR FAMILY MEDICINE - ADAMS COUNTY DENTAL CLINIC
Entity TypeOrganization
Authorized ContactIRIS WESLEY
CEO
217-545-8000
Organization Subpart ?Yes
Primary Taxonomy261QF0400X Clinic/Center Federally Qualified Health Center (FQHC)
Enumeration Date2018-01-05
Last Update Date2018-01-05
Business Address
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
330 VERMONT ST STE 100
QUINCY, IL 62301-2700
Phone number: 217-222-8440
Mailing Address
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
PO BOX 19639
SPRINGFIELD, IL 62794-9639
Phone number: 217-545-7876