Organization
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Active
Other names
SIU CENTER FOR FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS WESLEY (CEO)
(217) 545-8000
Entity
Organization
Contact information
Practice address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 757-8100
(217) 747-1351
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(217) 545-4410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
IL
Other
Enumeration date
10/08/2012
Last updated
04/20/2026
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