| Southern Illinois Healthcare Foundation, Inc | |
|
7210 W Main St Belleville IL 62223-3038 | |
| (618) 394-0712 | |
| (618) 394-1346 |
| Full Name | Southern Illinois Healthcare Foundation, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7210 W Main St, Belleville, Illinois |
| Authorized Official Name and Position | Larry Mcculley (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6183320694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Healthcare Foundation, Inc 8080 State St East Saint Louis IL 62203-1808 Ph: (618) 397-3303 | Southern Illinois Healthcare Foundation, Inc 7210 W Main St Belleville IL 62223-3038 Ph: (618) 394-0712 |
| NPI Number | 1275561797 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 11/03/2011 |
| Medicare PECOS PAC ID | 1456256874 |
|---|---|
| Medicare Enrollment ID | O20081029000949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275561797 | NPI | - | NPPES |
| 732740 | Other | IL | WPS MEDICARE GROUP NUMBER |
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