SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. (NPI# 1487719860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487719860 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Other Organization Name | BETHALTO HEALTH CENTER |
| Practice Address |
2 Terminal Dr Suite 8 East Alton IL 62024-2268 |
| Mailing Address |
8080 State St East Saint Louis IL 62203-1808 |
| Practice Telephone | 6182580485 |
| Practice Fax Number | 6182580489 |
| Mailing Telephone | 6183973303 |
| Mailing Fax Number | 6183977802 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. LARRY MCCULLEY (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6183320783 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bethalto 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 |
2 TERMINAL DR SUITE 8 |
| City | EAST ALTON |
| State | IL |
| Zip Code | 62024-2268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427099159 | Anupama Vallala | Pediatrics | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2006-06-10 |
| 1124473046 | Heidi Fields | Nurse Practitioner | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2016-04-28 |
| 1194148544 | Affiance Home Health Services, LLC | Home Health | 2 Terminal Dr, Suite 19, East Alton, IL 62024-2201 | 2014-01-21 |
| 1700194750 | Jacob Funk | Chiropractor | 2 Terminal Dr, Suite 15, East Alton, IL 62024-2268 | 2010-09-23 |
| 1295062537 | Danielle L. Bogue | Nurse Practitioner | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2009-11-06 |
| 1780822734 | Gretchen D Jackson | Counselor | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2009-01-29 |
| 1154500254 | Nurses Station, P.C. | Registered Nurse | 2 Terminal Dr, Suite 1, East Alton, IL 62024-2201 | 2007-10-25 |
| 1518150481 | Anthony B Chin | Dentist | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2007-08-23 |
| 1053504506 | Nanthini Suthan | Internal Medicine | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2007-08-18 |
| 1750439279 | Sonia Marie Matthews | Obstetrics & Gynecology | 2 Terminal Dr, Suite 8, East Alton, IL 62024-2201 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326395153 | Leah Marie Nanney | Pharmacist | 550 W St Louis Avenue, East Alton, IL 62024 | 2012-08-10 |
| 1861681207 | M-lab Enterprises,ltd. | Chiropractor | 2 Termianl Dr. Ste. 15, East Alton, IL 62024 | 2007-10-22 |
| 1184846628 | Affordable Dentistry Today, PC | Dentist | 50 North Center Street, East Alton, IL 62024 | 2007-05-03 |
| 1386769255 | Sarah Crockett | Occupational Therapy Assistant | 8 Carmelita Drive, East Alton, IL 62024 | 2007-03-20 |
| 1922155886 | Ruth Cohen Kubicek | Social Worker | 9 Junction Drive West, Suite 2, Glen Carbon, IL 62024 | 2007-01-04 |
| 1952356578 | Andrew W Dykeman | Chiropractor | 33 East Airline Drive, East Alton, IL 62024 | 2006-05-23 |
| 1093771883 | Gateway Rehabilitation Company, LLC | Physical Therapist | 935 East Airline Dr, East Alton, IL 62024 | 2006-04-21 |
| 1265795025 | Tania Evans | Counselor | 211 N Shamrock St, East Alton, IL 62024-0016 | 2012-06-18 |
| 1114202280 | Dana Sue Livingston | Pharmacist | 550 W Saint Louis Ave, East Alton, IL 62024-1044 | 2011-10-19 |
| 1407259971 | Michelle Sawyer | Counselor | 515 Niagara St, East Alton, IL 62024-1087 | 2014-09-29 |
| Find all providers in zip 62024 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 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 | EAST ALTON |
| Zip Code | 62024 |
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.