# BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396386181
- **Authorized official:** IRIS WESLEY (CEO)
- **Authorized official phone:** (217) 545-8000

## Contact information

- **Practice address:** 300 W OAK ST STE 100, CARBONDALE, IL 62901-1496
- **Practice address phone:** (618) 536-6621
- **Mailing address:** PO BOX 19639, SPRINGFIELD, IL 62794-9639
- **Mailing address phone:** (217) 545-7876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/02/2019
- **Last updated:** 10/02/2019