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
345 W STATE ST
JACKSONVILLE, IL62650-1879
Phone: 217-245-5111
Fax: 217-243-4773
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

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

NPI Number 1649628009
Legal business name
LBN
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Authorized official IRIS WESLEY - (CEO)
Entity Organization
Organization subpart No
Enumeration date 05/26/2016
Last updated 05/26/2016 - About 10 years 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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