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Contact Information

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
5220 S 6TH STREET RD
SUITE 1500
SPRINGFIELD, IL62703-5735
 Phone: 217-545-8000
 Fax: 217-747-1351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

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

NPI Number 1518343722
LBN Legal business name BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Authorized official IRIS WESLEY - (CEO/FQHC DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/11/2015
Last updated 08/13/2015 - About 11 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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