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Organization
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Active
Organization
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS WESLEY (CEO)
(217) 545-8000
Entity
Organization
Contact information
Practice address
300 W OAK ST STE 100, CARBONDALE, IL 62901-1496
(618) 536-6621
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7876
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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