Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Active
Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Active
Other names
Effingham Health Center II
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY MCCULLEY (COO)
(618) 332-0649
Entity
Organization
Contact information
Practice address
900 W TEMPLE AVE, SUITE 103, EFFINGHAM, IL 62401-2121
(618) 397-3303
(618) 397-7802
Mailing address
8080 STATE ST, EAST SAINT LOUIS, IL 62203-1808
(618) 397-3303
(618) 397-7802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/06/2007
Last updated
06/13/2008
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