SOUTHERN ILLINOIS HEALTHCARE FOUNDATION. INC. (NPI# 1023371143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023371143 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION. INC. |
| Other Organization Name | MATTOON MEDICAL CENTER |
| Practice Address |
700 Broadway Ave E Mattoon IL 61938-4671 |
| Mailing Address |
2041 Goose Lake Rd Sauget IL 62206-2822 |
| Practice Telephone | 2172343091 |
| Practice Fax Number | 2172343094 |
| Mailing Telephone | 6183320953 |
| Mailing Fax Number | 6183322487 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |
| Authorized Official Name | MR. LARRY MCCULLEY (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) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mattoon Medical Center | Doing Business As Name - Organization |
| Street Address |
700 BROADWAY AVE E |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-4671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215992805 | Mary H Mcguire | Nurse Practitioner | 700 Broadway Ave E, Suite 39, Mattoon, IL 61938-4671 | 2006-04-18 |
| 1154788545 | Coles County Mental Health Association, Inc. | Community/Behavioral Health | 700 Broadway Ave E, Mattoon, IL 61938-4671 | 2016-01-15 |
| 1588862254 | Kenneth Lee Myracle | Dentist | 700 Broadway Ave E, Mattoon, IL 61938-4671 | 2007-07-04 |
| 1386713899 | Sarah Bush Lincoln Health Center Durable Medical Equipment | Durable Medical Equipment & Medical Supplies | 700 Broadway Ave E, Suite 9, Mattoon, IL 61938-4671 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| 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 |
|---|---|---|---|---|
| 1235455130 | Community Health Improvement Center | Clinic/Center | 700 Broadway Avenue East, Suite 39, Mattoon, IL 61938-4662 | 2010-04-16 |
| 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 | ||||
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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.