| Southern Illinois Health Care Foundation, Inc. | |
|
4 Memorial Dr Ste 210 Alton IL 62002 | |
| (618) 463-5905 | |
| Not Available |
| Full Name | Southern Illinois Health Care Foundation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4 Memorial Dr Ste 210, Alton, Illinois |
| Authorized Official Name and Position | Larry Mcculley (PRESIDENT/CEO) |
| 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 Health Care Foundation, Inc. 2041 Goose Lake Rd Sauget IL 62206-2822 Ph: (618) 332-0953 | Southern Illinois Health Care Foundation, Inc. 4 Memorial Dr Ste 210 Alton IL 62002 Ph: (618) 463-5905 |
| NPI Number | 1376589226 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 08/16/2018 |
| Medicare PECOS PAC ID | 1456256874 |
|---|---|
| Medicare Enrollment ID | O20081029000941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376589226 | NPI | - | NPPES |
| 732740 | Other | IL | WPS MEDICARE GROUP NUMBER |
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