NPI 1386825412

Southern Illinois Healthcare Foundation, INC.

Organisation Federally Qualified Health Center (FQHC) Pontoon Beach, IL

Practice location

Address: 3924 Oakmont Dr, Pontoon Beach, IL 62040-4395
Phone: (618) 397-3303
Fax: (618) 397-7802
Mailing address: 8080 State St, East Saint Louis, IL 62203-1808

Authorised official

Name: Larry McCulley
Title: Coo
Phone: (618) 332-0694

Registered specialties (3)

Federally Qualified Health Center (FQHC) Primary

Ambulatory Health Care Facilities Taxonomy 261QF0400X

Other Clinic/Center providers in Illinois →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Illinois →

Psychiatry Physician

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X

Other Psychiatry & Neurology providers in Illinois →

Registry record

NPI: 1386825412
Entity type: Organization
NPI issued: 16 Nov 2007
Record last updated: 16 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.