Organization
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Active
Other names
SIU CENTER FOR FAMILY MEDICINE-JACKSONVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS WESLEY (CEO)
(217) 545-8000
Entity
Organization
Contact information
Practice address
345 W STATE ST, JACKSONVILLE, IL 62650-1879
(217) 245-5111
(217) 243-4773
Mailing address
520 N 4TH ST, PO BOX 19671, SPRINGFIELD, IL 62702-5238
(217) 545-8000
(217) 747-1351
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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