NPI Profile for SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC in CAHOKIA, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
363LS0200X | 50 | Nurse Practitioner | |
Federally Qualified Health Center (FQHC) |
261QF0400X | B4[14] | Federally Qualified Health Center |
| NPI # | 1689739062 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/26/2006 | |
| Last updated | 09/11/2025 - About 9 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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