BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY (NPI# 1851934871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851934871 |
| Entity Type | Organization |
| Organization Name | BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY |
| Practice Address |
303 E Bidwell St Taylorville IL 62568-1363 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2178243566 |
| Mailing Telephone | 2175457876 |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |
| 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 |
| 1619501871 | Board of Trustees of Southern Illinois University | Clinic/Center | 606 W Adams St, Pittsfield, IL 62363-1308 | 2020-02-26 |
| 1023585312 | Board of Trustees of Southern Illinois University | Clinic/Center | 2833 S Grand Ave E, Springfield, IL 62703-2175 | 2018-10-25 |
| Street Address |
303 E BIDWELL ST |
| City | TAYLORVILLE |
| State | IL |
| Zip Code | 62568-1363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235316191 | Springfield Clinic, LLP | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2008-01-23 |
| 1558910794 | Mental Health Centers of Central Illinois | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2019-09-10 |
| 1245498104 | Taylorville Medical Associates Lab | Clinical Medical Laboratory | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2008-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619481629 | Kimberly Denae Washburn | Social Worker | 1100 Sandy Duncan Dr, Taylorville, IL 62568 | 2017-11-29 |
| 1043729841 | Christian County Young Men's Christian Association Inc | Health Educator | 900 Mcadam Dr, Taylorville, IL 62568 | 2017-09-25 |
| 1326597014 | Pamela A Napier | Case Manager/Care Coordinator | 610 S Webster St, Taylorville, IA 62568 | 2016-09-23 |
| 1619169364 | Ronald Eugene Mizer | Dentist | 400 West Main Cross, Taylorville, IL 62568 | 2007-08-16 |
| 1881770816 | Rosalina R. Gonzales | Family Medicine | Route 29 South, Taylorville, IL 62568 | 2006-10-31 |
| 1790868917 | Wal-mart Stores, Inc | Technician/Technologist | 1530 W. Springfield Rd., Taylorville, IL 62568 | 2006-10-23 |
| 1265514285 | Dr Timothy Hutson Dentist | Dentist | 929 W Spresser St, Taylorville, IL 62568 | 2006-10-19 |
| 1336220565 | Peggy Tell | Counselor | 730 North Pawnee, Taylorville, IL 62568 | 2006-10-17 |
| 1306946777 | Gateway Rehabilitation Taylorville LLC | Clinic/Center | 301-305 S Webster, Taylorville, IL 62568 | 2006-09-25 |
| 1497779763 | Richard Lee Zimmers | Dentist | 101 S Cherokee Street, Taylorville, IL 62568 | 2006-07-27 |
| Find all providers in zip 62568 | ||||
| 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 | TAYLORVILLE |
| Zip Code | 62568 |
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.