NPI | 1568210425 |
---|---|
Doing Business As | SIU CENTER FOR FAMILY MEDICINE - CARE-A-VAN |
Entity Type | Organization |
Authorized Contact | IRIS WESLEY CEO 217-757-8137 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-05-07 |
Last Update Date | 2024-05-07 |