SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. (NPI# 1033573183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033573183 |
Entity Type | Organization |
Organization Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
Other Organization Name | RED BUD HEALTH CENTER |
Practice Address |
824 Locust St Red Bud IL 62278-1209 |
Mailing Address |
2041 Goose Lake Rd Sauget IL 62206-2822 |
Practice Telephone | 6182826656 |
Mailing Telephone | 6183320694 |
Enumeration Date | 2016-04-05 |
Last Update Date | 2016-04-05 |
Authorized Official Name | MR. LARRY MCCULLEY (PRESIDENT/CEO) |
Authorized Official Telephone | 6183320694 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
IL | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Red Bud Health Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659506939 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 144 N Washington St, Bunker Hill, IL 62014-1316 | 2009-05-15 |
1255514717 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 308 Madison Ave, Madison, IL 62060-1110 | 2007-12-07 |
1013198712 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 502 W Virginia Ave, Effingham, IL 62401-2260 | 2007-11-21 |
1568643260 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1832 Cleveland Blvd, Granite City, IL 62040-4500 | 2007-11-21 |
1740461870 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1425 6th St, Madison, IL 62060-1417 | 2007-11-16 |
1023299153 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1218 19th St, Granite City, IL 62040-4501 | 2007-11-16 |
1750562880 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2054 Edison Ave, Granite City, IL 62040-4540 | 2007-11-16 |
1386825412 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 3924 Oakmont Dr, Pontoon Beach, IL 62040-4395 | 2007-11-16 |
1316126147 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 648 State St, Madison, IL 62060-1420 | 2007-10-29 |
1821277658 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2057 Edison Ave, Suite A, Granite City, IL 62040-4514 | 2007-10-29 |
Street Address |
824 LOCUST ST |
City | RED BUD |
State | IL |
Zip Code | 62278-1209 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144672627 | Shelley Dawn Reichling | Nurse Practitioner | 824 Locust St, Red Bud, IL 62278-1209 | 2016-07-07 |
1437130507 | David A Walls | Family Medicine | 824 Locust St, Red Bud, IL 62278-1209 | 2005-11-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477852028 | Margret De Jesus De Guzman | Surgery | Red Bud Illinois Hospital Comany LLC, 325 Spring St, Red Bud, IL 62278 | 2011-03-22 |
1952595878 | Clarkson Optometry Illinois PC | Optometrist | 210 S Main, Red Bud, IL 62278 | 2007-09-04 |
1679795157 | Human Service Center of Southern Metro East | Clinic/Center | 10257 State Route Three, Red Bud, IL 62278 | 2007-05-03 |
1508980798 | Quentin Thomas Stenzel | Chiropractor | 204 W. Market, Red Bud, IL 62278 | 2007-03-16 |
1306905054 | Jennifer Ranee Dewilde | Chiropractor | 930 West Market, Suite 1, Red Bud, IL 62278 | 2006-12-08 |
1588147623 | Thomas Michael Castilaw | Nurse Practitioner | 325 Spring St, Red Bud, IL 62278 | 2018-09-14 |
1336353523 | Human Service Center | Private Vehicle | 10257 State Route Three, Red Bud, IL 62278 | 2007-05-09 |
1093928111 | Human Service Center | Clinic/Center | 10257 State Route Three, Red Bud, IL 62278 | 2007-05-07 |
1386856409 | Human Service Center of Southern Metro East | Clinic/Center | 115 East Stacey Street, Chester, IL 62278 | 2007-05-03 |
1417960121 | Tina Renee Stulce | Dentist | 307 S Main St, Red Bud, IL 62278 | 2006-08-14 |
Find all providers in zip 62278 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417567108 | Pillars Community Health | Clinic/Center | 15w458 91st St, Burr Ridge, IL 60527-6379 | 2020-08-06 |
1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC..
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.