| Southern Illinois Healthcare Foundation, Inc. | |
| 
					2568 N 41st St East Saint Louis IL 62201-2204  | |
| (618) 482-4015 | |
| (618) 482-4806 | 
| Full Name | Southern Illinois Healthcare Foundation, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 2568 N 41st St, East Saint Louis, Illinois | 
| Authorized Official Name and Position | Larry Mcculley (PRESIDENT) | 
| Authorized Official Contact | 6183320783 | 
| 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. 2568 N 41st St East Saint Louis IL 62201-2204 Ph: (618) 482-4015  | 
| NPI Number | 1770648917 | 
|---|---|
| Provider Enumeration Date | 12/27/2006 | 
| Last Update Date | 07/29/2009 | 
| Medicare PECOS PAC ID | 1456256874 | 
|---|---|
| Medicare Enrollment ID | O20081030000237 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1770648917 | NPI | - | NPPES | 
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 James R Thompson Blvd, Building D, Suite 2015, East Saint Louis, IL 62201 Phone: 618-482-6959 Fax: 618-482-8311  | |
Southern Illinois Healthcare Foundation, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 State St, East Saint Louis, IL 62205 Phone: 618-271-0207 Fax: 618-271-9617  | |
Southern Illinois Healthcare Foundation, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6010 Bond Ave, East Saint Louis, IL 62207 Phone: 618-337-8153 Fax: 618-337-8905  | |
Southern Illinois Regional Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1736 Kingshighway, East Saint Louis, IL 62204 Phone: 618-874-3120 Fax: 618-215-4048  | |
Roadside Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 699 State Route 203, Suite 1, East Saint Louis, IL 62201 Phone: 941-225-2520 Fax: 888-860-8609  | |
Southern Illinois Health Care Foundation, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Jackie Joyner Kersee Cir, East Saint Louis, IL 62204 Phone: 618-332-9484  | |
Southern Illinois Healthcare Foundation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 540 N 6th St, East Saint Louis, IL 62201 Phone: 618-397-3303 Fax: 618-397-3303  |