Organization
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE
Active
Organization
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE
Active
Parent organization
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE
Authorized official
NANCY UFERT (DIRECTOR OF PURCHASING)
(618) 650-3255
Entity
Organization
Contact information
Practice address
601 JAMES R THOMPSON BLVD, BUILDING D 2015, EAST SAINT LOUIS, IL 62201-1129
(618) 482-6959
(618) 482-8311
Mailing address
601 JAMES R THOMPSON BLVD, BUILDING D 2015, EAST SAINT LOUIS, IL 62201-1129
(618) 482-6959
(618) 482-8311
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/14/2007
Last updated
07/29/2008
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