| Board Of Trustees Of Southern Illinois University | |
|
4409 Maine St Ste 100 Quincy IL 62305-5849 | |
| (217) 919-9139 | |
| (217) 223-0461 |
| Full Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Speciality | Clinic/Center |
| Location | 4409 Maine St Ste 100, Quincy, Illinois |
| Authorized Official Name and Position | Iris Wesley (CEO) |
| Authorized Official Contact | 2175458000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of Southern Illinois University Po Box 19639 Springfield IL 62794-9639 Ph: (217) 545-7876 | Board Of Trustees Of Southern Illinois University 4409 Maine St Ste 100 Quincy IL 62305-5849 Ph: (217) 919-9139 |
| NPI Number | 1003324260 |
|---|---|
| Provider Enumeration Date | 01/22/2018 |
| Last Update Date | 01/09/2025 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20180403002167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003324260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Blessing Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 420 N 34th St, Quincy, IL 62301 Phone: 217-214-9626 Fax: 217-214-9627 | |
Blessing Walk-in Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Harrison St, Quincy, IL 62301 Phone: 217-223-8400 | |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Vermont St Ste 100, Quincy, IL 62301 Phone: 217-222-8440 Fax: 217-222-8508 | |
Blessing Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1005 Broadway St, Quincy, IL 62301 Phone: 217-223-8400 Fax: 217-223-9945 | |
Preferred Family Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 540 Harrison St, Quincy, IL 62301 Phone: 573-603-1460 Fax: 573-603-1462 | |
Blessing Walk-in Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 Broadway St, Quincy, IL 62305 Phone: 217-228-1060 |