| NPI | 1821511783 |
|---|---|
| Doing Business As | SIU CENTER FOR FAMILY MEDICINE - INTEGRATED WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | IRIS WESLEY Chief Executive Officer 217-545-7876 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2025-01-09 |