BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY (NPI# 1619501871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619501871 |
| Entity Type | Organization |
| Organization Name | BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY |
| Practice Address |
606 W Adams St Pittsfield IL 62363-1308 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2175457876 |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | IRIS WESLEY (CEO) |
| Authorized Official Telephone | 2175458000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
| 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 |
| 1558848473 | Board of Trustees of Southern Illinois University | Clinic/Center | 2833 S Grand Ave E Ste 100, Springfield, IL 62703-2175 | 2018-07-24 |
| 1003324260 | Board of Trustees of Southern Illinois University | Clinic/Center | 4409 Maine St Ste 100, Quincy, IL 62305-5849 | 2018-01-22 |
| 1083121537 | Board of Trustees of Southern Illinois University | Clinic/Center | 330 Vermont St Ste 100, Quincy, IL 62301-2700 | 2018-01-05 |
| 1922515451 | Board of Trustees of Southern Illinois University | Clinic/Center | 330 Vermont St Ste 211, Quincy, IL 62301-2700 | 2018-01-05 |
| 1679188437 | Board of Trustees of Southern Illinois University | Clinic/Center | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2020-09-09 |
| 1851934871 | Board of Trustees of Southern Illinois University | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2019-10-22 |
| 1023585312 | Board of Trustees of Southern Illinois University | Clinic/Center | 2833 S Grand Ave E, Springfield, IL 62703-2175 | 2018-10-25 |
| Street Address |
606 W ADAMS ST |
| City | PITTSFIELD |
| State | IL |
| Zip Code | 62363-1308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548335862 | County of Pike | Registered Nurse | 606 W Adams St, Pittsfield, IL 62363-1308 | 2006-11-21 |
| 1114471869 | Kaydianne Grote | Dentist | 606 W Adams St, Pittsfield, IL 62363-1308 | 2016-08-11 |
| 1376868786 | County of Pike | Public Health or Welfare | 606 W Adams St, Pittsfield, IL 62363-1308 | 2010-03-30 |
| 1811178072 | Mary R Harris | Counselor | 606 W Adams St, Pittsfield, IL 62363-1308 | 2007-11-16 |
| 1871794925 | Quincy Medical Group Pittsfield Rural Health | Durable Medical Equipment & Medical Supplies | 606 W Adams St, Pittsfield, IL 62363-1308 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871831388 | Advance Physical Therapy Illini Community Hospital LLC | Physical Therapist | 128 W Washington Street, Pittsfield, IL 62363 | 2013-01-18 |
| 1003168154 | Rebecca L. Williams | Social Worker | 120 North Williams Industrial Drive, Pittsfield, IL 62363 | 2012-10-12 |
| 1851641534 | Debra Ann Helton | Speech-Language Pathologist | 640 West Washington, Pittsfield, IL 62363 | 2012-09-11 |
| 1366791451 | Blessing Care Corp. | Hospitalist | 640 West Washington Street, Pittsfield, IL 62363 | 2012-09-05 |
| 1235421900 | Mental Health Centers of Western Illinios | Community/Behavioral Health | 120 N. Williams Industrial Drive, Pittfield, IL 62363 | 2011-05-12 |
| 1003088188 | Brandi N. Ruzich | Physical Therapist | 320 N. Madison, Pittsfield, IL 62363 | 2008-03-28 |
| 1841494085 | Kelly Marie Baker | Counselor | 121 S Madison, Pittsfield, IL 62363 | 2007-06-12 |
| 1780885830 | Quincy Medical Group Pleasant Hill Rural Health | Durable Medical Equipment & Medical Supplies | 405 East State, Pleasant Hill, IL 62363 | 2007-05-29 |
| 1962622795 | Kelli R Hull | Licensed Practical Nurse | 121 South Madison Street, Mental Health Centers of Western Illinois, Pittsfield, IL 62363 | 2007-04-26 |
| 1407939085 | Wal-mart Stores, Inc | Technician/Technologist | Us 36 & 151 Shetland Dr., Pittsfield, IL 62363 | 2006-10-24 |
| Find all providers in zip 62363 | ||||
| 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 |
|---|---|---|---|---|
| 1942759162 | Community Health Programs, Inc | Clinic/Center | 510 North St., Pittsfield, MA 01201 | 2016-09-29 |
| 1396026803 | Sebasticook Family Doctors | Clinic/Center | 453 Main St, Pittsfield, ME 04967-5310 | 2011-08-30 |
| 1952637985 | Sebasticook Family Doctors | Clinic/Center | 140 Chandler St, Pittsfield, ME 04967-3711 | 2009-10-27 |
| 1649408899 | Community Health Programs, Inc | Clinic/Center | 510 North Street, Pittsfield, MA 01201 | 2009-06-26 |
| 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 | PITTSFIELD |
| Zip Code | 62363 |
Please comment or provide details below to improve the information on BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY.
| 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.