National Provider Identifier Database

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
4409 MAINE ST STE 100
QUINCY, IL62305-5849
Phone: 217-919-9139
Fax: 217-223-0461
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X
Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

NPI Number 1003324260
Legal business name
LBN
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Authorized official IRIS WESLEY - (CEO)
Entity Organization
Organization subpart Yes
Enumeration date 01/22/2018
Last updated 01/09/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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