SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. (NPI# 1689739062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689739062 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. |
| Other Organization Name | CAHOKIA SCHOOL BASED CENTER |
| Practice Address |
800 Range Ln Cahokia IL 62206-2022 |
| Mailing Address |
8080 State St East Saint Louis IL 62203-1808 |
| Practice Telephone | 6183373117 |
| Practice Fax Number | 6183373122 |
| Mailing Telephone | 6183973303 |
| Mailing Fax Number | 6183977802 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |
| 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 |
|---|---|---|---|---|---|
| X | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| X | 363LS0200X |
Nurse Practitioner Specialization: School |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Cahokia School Based 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 |
800 RANGE LN |
| City | CAHOKIA |
| State | IL |
| Zip Code | 62206-2022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225015456 | William H Thom | Anesthesiology | 12 Wolf Creek, Suite 200, Swansea, IL 62206 | 2005-12-29 |
| 1891784823 | Steven G Connors | Chiropractor | 1518 Camp Jackson Rd, Cahokia, IL 62206 | 2005-10-21 |
| 1558661454 | David J Cruse Jr. | Pharmacist | 1615 Camp Jackson Rd, Cahokia, IL 62206 | 2010-10-25 |
| 1477866671 | Ca Group LLC | Internal Medicine | 4043 Mississippi Ave, Cahokia, IL 62206-1041 | 2010-07-16 |
| 1396871794 | Cahokia Pharmacy Inc | Pharmacy | 817 Upper Cahokia Rd, Cahokia, IL 62206-1211 | 2007-02-27 |
| 1578629945 | Rosa M. Prouhet | Registered Nurse | 818 Upper Cahokia Rd, Cahokia, IL 62206-1212 | 2006-12-29 |
| 1518391739 | Sarah Rahman | Physician Assistant | 818 Upper Cahokia Rd, Cahokia, IL 62206-1212 | 2013-08-23 |
| 1902963028 | Southern Illinois Healthcare Foundation, Inc. | Nurse Practitioner | 818 Upper Cahokia Rd, Cahokia, IL 62206-1212 | 2007-01-02 |
| 1427114891 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 818 Upper Cahokia Rd, Cahokia, IL 62206-1212 | 2006-12-29 |
| 1649797838 | Marcia Ann Young | Behavior Technician | 17 Kinder St, Cahokia, IL 62206-1334 | 2017-08-28 |
| Find all providers in zip 62206 | ||||
| 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 | ||||
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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.