| Southern Illinois Healthcare Foundation, Inc. | |
|
2615 Edwards St Alton IL 62002-3915 | |
| (618) 462-4342 | |
| (618) 462-5334 |
| Full Name | Southern Illinois Healthcare Foundation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2615 Edwards St, Alton, 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. 2615 Edwards St Alton IL 62002-3915 Ph: (618) 462-4342 |
| NPI Number | 1235430323 |
|---|---|
| Provider Enumeration Date | 11/05/2010 |
| Last Update Date | 08/02/2011 |
| Medicare PECOS PAC ID | 1456256874 |
|---|---|
| Medicare Enrollment ID | O20110311000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235430323 | NPI | - | NPPES |
| 141142 | Other | IL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Illinois) | Primary |
Fairview Heights Medical Group Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 Regional Dr, Alton, IL 62002 Phone: 618-465-7080 Fax: 618-465-7080 | |
Southern Illinois Healthcare Foundation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4200 Humbert Rd, Alton, IL 62002 Phone: 618-332-0953 | |
Fairview Heights Medical Group Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Memorial Dr, Suite 220, Alton, IL 62002 Phone: 618-462-3191 | |
Cep America - Illinois Hospitalists, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Saint Anthonys Way, Alton, IL 62002 Phone: 618-465-2571 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3523 Wickenhauser Ave, Alton, IL 62002 Phone: 618-465-8887 | |
E J Aragona Md Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Northport Dr, Alton, IL 62002 Phone: 618-466-6177 Fax: 618-466-6388 |