NPI | 1649628009 |
---|---|
Doing Business As | SIU CENTER FOR FAMILY MEDICINE-JACKSONVILLE |
Entity Type | Organization |
Authorized Contact | IRIS WESLEY CEO 217-545-8000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2016-05-26 |
Last Update Date | 2016-05-26 |