| NPI | 1518343722 |
|---|---|
| Doing Business As | SIU CENTER FOR FAMILY MEDICINE - NOLL |
| Entity Type | Organization |
| Authorized Contact | IRIS WESLEY CEO/Fqhc Director 217-545-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-13 |