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Organization

SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.

Active
Other names
SIHF Healthcare, Alton Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY MCCULLEY (PRESIDENT/CEO)
(618) 332-0694
Entity
Organization

Contact information

Practice address
4 MEMORIAL DR STE 210, ALTON, IL 62002
(618) 463-5905
Mailing address
2041 GOOSE LAKE RD, SAUGET, IL 62206-2822
(618) 332-0953
(618) 332-2487

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
2084P0800X
Psychiatry Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
367A00000X
Advanced Practice Midwife

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
732740
WPS MEDICARE GROUP NUMBER
IL
Enumeration date
06/21/2006
Last updated
08/16/2018
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