| NPI | 1437708674 | 
|---|---|
| Doing Business As | SIU CENTER FOR FAMILY MEDICINE - CARBONDALE | 
| Entity Type | Organization | 
| Authorized Contact | IRIS WESLEY CEO 217-545-8000  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | 
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care | 
| Enumeration Date | 2019-09-10 | 
| Last Update Date | 2025-01-09 |