| Board Of Trustees Of Southern Illinois University | |
|
300 W Oak St Ste 100 Carbondale IL 62901-1496 | |
| (618) 453-3777 | |
| (618) 453-1102 |
| Full Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 300 W Oak St Ste 100, Carbondale, Illinois |
| Authorized Official Name and Position | Iris Wesley (C.E.O.) |
| Authorized Official Contact | 2175458137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of Southern Illinois University 201 E Madison St Ste 328 Springfield IL 62702-5131 Ph: (217) 545-6523 | Board Of Trustees Of Southern Illinois University 300 W Oak St Ste 100 Carbondale IL 62901-1496 Ph: (618) 453-3777 |
| NPI Number | 1215978127 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 05/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215978127 | NPI | - | NPPES |
| CE8688 | Other | IL | RR MEDICARE |
| CE8687 | Other | IL | RR MEDICARE |
| CE8689 | Other | IL | RR MEDICARE |
| CE8931 | Other | IL | RR MEDICARE |
| CB2589 | Other | IL | RR HEALTH |
| CE8686 | Other | IL | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 374 East Grand Avenue, Mail Code 674d, Carbondale, IL 62901 Phone: 618-453-3311 Fax: 618-453-4449 | |
The Carbondale Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-457-5200 Fax: 618-549-5128 | |
Community Health & Emergency Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 Cedar Ct, Carbondale, IL 62901 Phone: 618-351-1213 Fax: 618-351-1905 | |
Southern Illinois Gi Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1100 W Diann Ln, Carbondale, IL 62901 Phone: 618-549-8006 Fax: 618-549-8434 | |
Carbondale Community High Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Giant City Rd, Carbondale, IL 62902 Phone: 618-457-4722 Fax: 618-457-3353 | |
Southern Illinois Medical Services, Nfp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-549-5361 Fax: 618-351-4878 | |
Brown's Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 W Jackson St, Carbondale, IL 62901 Phone: 618-351-9559 |