BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

SPRINGFIELD, IL
NPI1184494619
Doing Business AsSIU MEDICINE NORTH DIRKSEN EXPRESS CARE
Entity TypeOrganization
Authorized ContactIRIS WESLEY
CEO
217-757-8137
Organization Subpart ?Yes
Primary Taxonomy261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)
Additional Taxonomies261QP2300X Clinic/Center, Primary Care
Enumeration Date2024-01-05
Last Update Date2025-01-09
Business Address
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
3220 ATLANTA ST STE 100
SPRINGFIELD, IL 62707-8801
Phone number: 217-545-4968
Mailing Address
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
PO BOX 19639
SPRINGFIELD, IL 62794-9639
Phone number: 217-545-8000