Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC
Active
Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC
Active
Other names
McKinley Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY W MCCULLEY (CEO)
(618) 332-0694
Entity
Organization
Contact information
Practice address
2166 MADISON AVENUE, GRANITE CITY, IL 62040
(618) 452-3301
(618) 452-3312
Mailing address
2041 GOOSE LAKE RD, SAUGET, IL 62206-2822
(618) 332-0953
(618) 332-2487
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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