| Southern Illinois Healthcare Foundation, Inc. | |
|
727 W Jackson St Vandalia IL 62471-1722 | |
| (618) 283-3144 | |
| (618) 283-3194 |
| Full Name | Southern Illinois Healthcare Foundation, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 727 W Jackson St, Vandalia, Illinois |
| Authorized Official Name and Position | Larry Mcculley (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 6183320783 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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. 727 W Jackson St Vandalia IL 62471-1722 Ph: (618) 283-3144 |
| NPI Number | 1518902006 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 03/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518902006 | NPI | - | NPPES |
| 201518 | Other | IL | WPS MEDICARE GROUP NUMBER |
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