institution
Board Of Trustees Of Southern Illinois University
Federally Qualified Health Center (FQHC) in Springfield, Illinois
NPI 1558848473

Board Of Trustees Of Southern Illinois University is a Federally Qualified Health Center (FQHC) based in Springfield, IL and is specialized in Federally Qualified Health Center (FQHC). Board Of Trustees Of Southern Illinois University practices in Springfield, IL. The NPI Number for Board Of Trustees Of Southern Illinois University is 1558848473 and holds a License No. (Illinois).

The current practice location address for Board Of Trustees Of Southern Illinois University is 2833 S Grand Ave E Ste 100, Springfield, IL and can be reached out via phone at 217-535-3100 and via fax at 217-535-3104. You can also correspond with Board Of Trustees Of Southern Illinois University through the mailing address at PO BOX 19639, SPRINGFIELD, IL - 62794-9639 (mailing address contact number: 217-545-7876).

Location: 2833 S Grand Ave E Ste 100, Springfield, IL, 62794-9639
institution
Provider Profile Details
NPI Number
1558848473
Provider Name
Board Of Trustees Of Southern Illinois University
Credential
Provider Entity Type
Organization
Address
2833 S Grand Ave E Ste 100, Springfield, IL, 62794-9639
Phone Number
217-535-3100
Fax Number
217-535-3104
Provider Enumeration Date
07/24/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2833 S Grand Ave E Ste 100
City
State
Zip
62703-2175
Phone Number
217-535-3100
Fax Number
217-535-3104
person
Provider Business Mailing Address Details
Address
2833 S Grand Ave E Ste 100
City
State
Zip
62703-2175
Phone Number
217-535-3100
Fax Number
217-535-3104
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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