SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.


Address: 824 Locust St, Red Bud, IL 62278-1209
Phone: 6182826656

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).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Red Bud Health Center Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 824 LOCUST ST
City RED BUD
State IL
Zip Code 62278-1209

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

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City RED BUD
Zip Code 62278

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Dataset Information

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.

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