| Southern Illinois Healthcare Foundation, Inc. | |
|
1120 N East St Olney IL 62450-6927 | |
| (618) 395-5222 | |
| (618) 395-8552 |
| Full Name | Southern Illinois Healthcare Foundation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1120 N East St, Olney, Illinois |
| Authorized Official Name and Position | Larry Mcculley (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 Healthcare Foundation, Inc. 2041 Goose Lake Rd Sauget IL 62206-2822 Ph: (618) 332-0953 | Southern Illinois Healthcare Foundation, Inc. 1120 N East St Olney IL 62450-6927 Ph: (618) 395-5222 |
| NPI Number | 1679844468 |
|---|---|
| Provider Enumeration Date | 01/25/2012 |
| Last Update Date | 08/27/2024 |
| Certification Date | 08/27/2024 |
| Medicare PECOS PAC ID | 1456256874 |
|---|---|
| Medicare Enrollment ID | O20120220000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679844468 | NPI | - | NPPES |
| 14-1156 | Other | IL | NGS MEDICARE |
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