Organization
SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.
Active
Organization
SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.
Active
Other names
Vivian's Village, SIHF Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MCCULLEY (CEO)
(618) 920-9484
Entity
Organization
Contact information
Practice address
432 VIVIAN WAY, ALORTON, IL 62207
(618) 646-2417
Mailing address
2041 GOOSE LAKE RD, SAUGET, IL 62206-2822
(618) 920-9484
(618) 920-9484
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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