SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC


Address: 6000 Bond Ave, Centreville, IL 62207-2328
Phone: 6183322740

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC (NPI# 1609813500) 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) 1609813500
Entity Type Organization
Organization Name SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Other Organization Name CENTREVILLE HEALTH CENTER
Practice Address 6000 Bond Ave
Centreville
IL 62207-2328
Mailing Address 2041 Goose Lake Rd
Sauget
IL 62206-2822
Practice Telephone 6183322740
Practice Fax Number 6183328755
Mailing Telephone 6183320953
Mailing Fax Number 6183977802
Enumeration Date 2006-05-31
Last Update Date 2016-05-26
Authorized Official Name MR. LARRY MCCULLEY (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 6183320694
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207V00000X Obstetrics & Gynecology Allopathic & Osteopathic Physicians
N 122300000X Dentist Dental Providers
N 208000000X Pediatrics Allopathic & Osteopathic Physicians
N 2080P0214X Pediatrics
Specialization: Pediatric Pulmonology
Allopathic & Osteopathic Physicians
N 2080P0202X Pediatrics
Specialization: Pediatric Cardiology
Allopathic & Osteopathic Physicians
N 2080P0207X Pediatrics
Specialization: Pediatric Hematology-Oncology
Allopathic & Osteopathic Physicians
N 2084N0402X Psychiatry & Neurology
Specialization: Neurology with Special Qualifications in Child Neurology
Allopathic & Osteopathic Physicians
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Centreville Health Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1619127289 Southern Illinois Healthcare Foundation Inc Family Medicine 540 N 6th St, East Saint Louis, IL 62201-1320 2008-09-19

Office Location

Street Address 6000 BOND AVE
City CENTREVILLE
State IL
Zip Code 62207-2328

Providers in the same location

NPI Name Taxonomy Address Enumeration
1386633295 Heather Surratt Dentist 6000 Bond Ave, Sihf - Mcc, Centreville, IL 62207-2328 2005-10-14
1730574617 Lara E. Stein Obstetrics & Gynecology 6000 Bond Ave, Centreville, IL 62207-2328 2015-03-30
1134546690 Bhawna Sharma Psychiatry & Neurology 6000 Bond Ave, Centreville, IL 62207-2328 2014-03-23
1629409362 Natascha R Jeffries Nurse Practitioner 6000 Bond Ave, Centreville, IL 62207-2328 2013-12-05
1700035730 Megan Lynette Preville Dentist 6000 Bond Ave, Dental Clinic, Centreville, IL 62207-2328 2008-09-15
1265612105 Donna Marie Meyers Registered Nurse 6000 Bond Ave, Centreville, IL 62207-2328 2007-11-08
1730245291 Marcia Mcgraw-houchens Registered Nurse 6000 Bond Ave, Centreville, IL 62207-2328 2006-12-29
1184608986 Bonnie J Summers Nurse Practitioner 6000 Bond Ave, Centreville, IL 62207-2328 2005-12-05
1689664286 Vandana Gupta Dentist 6000 Bond Ave, Centreville, IL 62207-2328 2005-10-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114493723 Monica Marie Magowan Nurse Practitioner Touchette Regional Hospital, 5900 Bond Ave, Centreville, IL 62207 2018-10-22
1063708345 Porshia Lenee' Egerson Student in an Organized Health Care Education/Training Program 6032 Clarita Ave, Centreville, IL 62207-1019 2011-06-24
1679742506 Comprehensive Mental Health Center of St. Clair County, Inc. Community/Behavioral Health 1501 S G St, East Saint Louis, IL 62207-2057 2008-02-25
1780853614 Comprehensive Mental Health Center of St. Clair County, Inc. Clinic/Center 1500 Wilford Ave, East Saint Louis, IL 62207-2066 2008-02-25
1891395893 Cheryl Lynn Eubanks Technician 1710 Mccasland Ave, East Saint Louis, IL 62207-2245 2020-10-28
1871086082 Medicate Pharmacy Inc Pharmacy 5869 Bond Ave, Centreville, IL 62207-2300 2018-06-12
1255357224 Mohammad Hashemi Radiology 5900 Bond Ave, East Saint Louis, IL 62207-2326 2006-07-14
1952900763 Danielle Victoria Williams Dietitian, Registered 5900 Bond Ave, Centreville, IL 62207-2326 2020-10-22
1750992459 Touchette Regional Hospital Inc Psychiatric Unit 5900 Bond Ave, Centreville, IL 62207-2326 2020-08-14
1932722295 Alecia E Marks Social Worker 5900 Bond Ave, Centreville, IL 62207-2326 2020-05-21
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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 city

NPI Name Taxonomy Address Enumeration
1316498041 Cahaba Medical Care Foundation Clinic/Center 260 Walnut St, Centreville, AL 35042-2332 2016-10-18
1063876910 Covered Bridge Healthcare of St. Joseph County Inc Clinic/Center 658 E Main St, Centreville, MI 49032-9699 2016-04-07
1780014449 Community Mental Health Services of St. Joseph County Clinic/Center 677 E Main St, Centreville, MI 49032-8524 2013-11-17
1316289515 Cahaba Medical Care Foundation Clinic/Center 405 Belcher St, Centreville, AL 35042-2946 2013-03-26
1316201809 Cahaba Medical Care Foundation Clinic/Center 195 Hospital Dr, Centreville, AL 35042-2935 2012-06-28

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

Search similar providers

City CENTREVILLE
Zip Code 62207

Improve Information

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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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