SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. (NPI# 1316126147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316126147 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Other Organization Name | SIHF MADISON RECOVERY FACILITY |
| Practice Address |
648 State St Madison IL 62060-1420 |
| Mailing Address |
8080 State St East Saint Louis IL 62203-1808 |
| Practice Telephone | 6183973303 |
| Practice Fax Number | 6183977802 |
| Mailing Telephone | 6183973303 |
| Mailing Fax Number | 6183977802 |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |
| Authorized Official Name | MR. LARRY MCCULLEY (COO) |
| 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 | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SIHF MADISON RECOVERY FACILITY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033573183 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 824 Locust St, Red Bud, IL 62278-1209 | 2016-04-05 |
| 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 |
| 1821277658 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2057 Edison Ave, Suite A, Granite City, IL 62040-4514 | 2007-10-29 |
| Street Address |
648 STATE ST |
| City | MADISON |
| State | IL |
| Zip Code | 62060-1420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073936530 | Kendra Jean Donaldson | Social Worker | 648 State St, Madison, IL 62060-1420 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255514717 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 308 Madison Ave, Madison, IL 62060-1110 | 2007-12-07 |
| 1851305668 | Jason F. Kesselring | Pediatrics | 304 Madison Ave, Madison, IL 62060-1110 | 2006-07-28 |
| 1376959668 | Stay At Home Health Care Inc | Home Health | 1130 Douglas St, Madison, IL 62060-1122 | 2014-07-07 |
| 1174796734 | Madison County Urban League | Clinic/Center | 500 Madison Ave, Madison, IL 62060-1414 | 2008-04-03 |
| 1740461870 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1425 6th St, Madison, IL 62060-1417 | 2007-11-16 |
| 1790083095 | Chestnut Health Systems, Inc | Case Management | 1425 6th St, Madison, IL 62060-1417 | 2011-03-10 |
| 1770850075 | Chestnut Health Systems, Inc. | Clinic/Center | 648 State St Bldg B, Madison, IL 62060-1420 | 2011-11-30 |
| 1902184054 | Chestnut Health Systems, Inc. | Clinic/Center | 648 State St Bldg A, Madison, IL 62060-1420 | 2011-07-22 |
| 1033310099 | County of Madison Community Unit School Dist 12 | Local Education Agency (LEA) | 1707 4th St, Madison, IL 62060-1505 | 2007-05-29 |
| 1598248106 | Granite City Clinic Corp | Clinic/Center | 602 Farrish St, Madison, IL 62060-1567 | 2018-09-10 |
| Find all providers in zip 62060 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1285872358 | Access Community Health Centers, Inc. | Clinic/Center | 2901 W Beltline Hwy, Suite 120, Madison, WI 53713-4226 | 2009-01-28 |
| 1740450089 | Womencare, Inc | Clinic/Center | 515 Main St, Madison, WV 25130-1417 | 2008-03-03 |
| 1669654307 | Access Community Health Centers, Inc. | Clinic/Center | 1102 S Park St, Madison, WI 53715-1714 | 2007-12-05 |
| 1760661714 | United Neighborhood Health Services, Inc | Clinic/Center | 601 W Due West Ave, Madison, TN 37115 | 2007-10-26 |
| 1568675858 | Access Community Health Centers, Inc. | Clinic/Center | 2202 S Park St, Madison, WI 53713-1916 | 2007-05-07 |
| Find all providers in MADISON | ||||
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| 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.