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).
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 |
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 Name | Type Code |
---|---|
Centreville Health Center | Doing Business As Name - Organization |
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 |
Street Address |
6000 BOND AVE |
City | CENTREVILLE |
State | IL |
Zip Code | 62207-2328 |
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 |
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 |
Find all providers in zip 62207 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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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 |
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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 |
City | CENTREVILLE |
Zip Code | 62207 |
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.