Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Active
Other names
Windsor Health Center II
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY MCCULLEY (CEO)
(618) 332-0783
Entity
Organization
Contact information
Practice address
100 N 8TH ST, SUITE 124, EAST SAINT LOUIS, IL 62201-2989
(618) 397-3303
Mailing address
8080 STATE ST, EAST SAINT LOUIS, IL 62203-1808
(618) 332-0953
(618) 332-2487
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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