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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