Southern Illinois Healthcare Foundation, Inc is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in East St Louis, Illinois. The current practice location for Southern Illinois Healthcare Foundation, Inc is 100 N 8th St, East St Louis, Illinois. For appointments, you can reach them via phone at
(618) 274-9105. The mailing address for Southern Illinois Healthcare Foundation, Inc is 8080 State St, East Saint Louis, Illinois and phone number is (618) 397-3303.
Southern Illinois Healthcare Foundation, Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1831125038. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(618) 274-9105.
Primary Care Clinic Profile
| Full Name | Southern Illinois Healthcare Foundation, Inc |
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| Speciality | Clinic/Center |
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| Location | 100 N 8th St, East St Louis, Illinois |
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| Authorized Official Name and Position | Larry Mcculley (PRESIDENT) |
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| Authorized Official Contact | 6183320783 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Southern Illinois Healthcare Foundation, Inc
8080 State St
East Saint Louis
IL 62203-1808
Ph: (618) 397-3303 | Southern Illinois Healthcare Foundation, Inc
100 N 8th St
East St Louis
IL 62201-2989
Ph: (618) 274-9105 |
NPI Details:
| NPI Number | 1831125038 |
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| Provider Enumeration Date | 06/23/2006 |
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| Last Update Date | 07/29/2009 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 1456256874 |
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| Medicare Enrollment ID | O20081030000255 |
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Medical Identifiers
Medical identifiers for Southern Illinois Healthcare Foundation, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831125038 | NPI | - | NPPES |
| 732740 | Other | IL | WPS MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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