BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

SPRINGFIELD, IL
NPI1558099523
Doing Business AsSIU FQHC - GENERAL INTERNAL MEDICINE CLINIC
Entity TypeOrganization
Authorized ContactIRIS WESLEY
CEO
217-757-8137
Organization Subpart ?Yes
Primary Taxonomy261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)
Enumeration Date2022-08-09
Last Update Date2022-08-09
Business Address
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
747 N RUTLEDGE ST STE 2287-B
SPRINGFIELD, IL 62702-6700
Phone number: 217-545-8000
Mailing Address
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
PO BOX 19639
SPRINGFIELD, IL 62794-9639
Phone number: 217-545-8000