Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Active
Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Active
Other names
SIHF Healthcare, SIHF Healthcare - Washington Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY MCCULLEY (PRESIDENT/CEO)
(618) 332-0694
Entity
Organization
Contact information
Practice address
1736 KINGSHIGHWAY, EAST SAINT LOUIS, IL 62204
(618) 874-3120
Mailing address
8080 STATE ST, EAST SAINT LOUIS, IL 62203-1808
(618) 397-3303
(618) 397-7802
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/26/2006
Last updated
06/27/2019
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