SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. (NPI# 1114116514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114116514 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Other Organization Name | SOUTHERN HEALTH CENTER |
| Practice Address |
12 N 64th St Suite 7 Belleville IL 62223-3809 |
| 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 | 2007-10-22 |
| Last Update Date | 2008-04-20 |
| 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 |
|---|---|
| Southern Health Center | 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 |
| 1316126147 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 648 State St, Madison, IL 62060-1420 | 2007-10-29 |
| Street Address |
12 N 64TH ST SUITE 7 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62223-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457453615 | Kayla Lynne Anderson | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2006-09-01 |
| 1043846587 | Kelsey Stott | Social Worker | 12 N 64th St, Belleville, IL 62223-3809 | 2020-03-17 |
| 1982252201 | Alondra Anderson | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2019-08-29 |
| 1699236455 | Monique Marie Stroud | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2019-03-26 |
| 1194280008 | Melissa Marie Huebner | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2019-02-05 |
| 1790273795 | Joshua B Theiss | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2018-04-25 |
| 1891203535 | Jessica Elizabeth Biffar | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2018-01-16 |
| 1376058164 | Anna Pereira | Counselor | 12 N 64th St, Belleville, IL 62223-3809 | 2017-12-04 |
| 1831634237 | Chestnut Health Systems, Inc | Clinic/Center | 12 N 64th St, Belleville, IL 62223-3809 | 2016-12-21 |
| 1427591015 | Brandy Hart | Counselor | 12 N 64th St, Suite 5, Belleville, IL 62223-3809 | 2016-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699211268 | Vip Home Health Services, LLC | Home Health | 9454 West Main Street Suite B, Belleville, IL 62223 | 2017-01-06 |
| 1659746063 | Carmel Brown | Counselor | 6400 West Main Suite 3f, Suite 3f, Belleville, IL 62223 | 2015-12-10 |
| 1558743138 | Patrick Nakashima-moran | Family Medicine | 2900 Frank Scott Pkwy W Ste 904, Belleville, IL 62223 | 2015-06-19 |
| 1982039921 | Megan Nicole Kirk | Counselor | 8601 W Main St Ste 201, Belleville, IL 62223 | 2013-09-10 |
| 1043555758 | Toni Green | Physical Therapy Assistant | 400 S 74th St, Belleville, IL 62223 | 2012-12-06 |
| 1356626949 | Christopher Patrick Gagen | Pharmacist | 5890 North Belt West, Belleville, IL 62223 | 2011-10-15 |
| 1861777690 | Carmicheal LLC | General Practice | 8601 West Main St., Ste. 101, Belleville, IL 62223 | 2011-10-12 |
| 1275824096 | Pc Associates LLC | Family Medicine | 2129 W. Main St., Belleville, IL 62223 | 2011-04-27 |
| 1053616763 | Abdurrahim M Abdulhadi | Anesthesiology | 4500 Mem. Drive, The Memorial Hospital, Belleville, IL 62223 | 2011-01-12 |
| 1801031695 | Jose Jesus Morales | Anesthesiology | 204 Warrensburg Drive, Belleville, IL 62223 | 2008-12-08 |
| Find all providers in zip 62223 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | BELLEVILLE |
| Zip Code | 62223 |
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.