| Board Of Trustees Of Southern Illinois University | |
|
606 W Adams St Pittsfield IL 62363-1308 | |
| (217) 545-8000 | |
| Not Available |
| Full Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Speciality | Clinic/Center |
| Location | 606 W Adams St, Pittsfield, Illinois |
| Authorized Official Name and Position | Iris Wesley (CEO) |
| Authorized Official Contact | 2175458000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of Southern Illinois University Po Box 19639 Springfield IL 62794-9639 Ph: (217) 545-7876 | Board Of Trustees Of Southern Illinois University 606 W Adams St Pittsfield IL 62363-1308 Ph: (217) 545-8000 |
| NPI Number | 1619501871 |
|---|---|
| Provider Enumeration Date | 02/26/2020 |
| Last Update Date | 02/26/2020 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20200930002015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619501871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Quincy Medical Group Pittsfield Affiliate Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 320 North Madison, Pittsfield, IL 62363 Phone: 217-285-9601 | |
Illini Community Hospital Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 321 W Washington St, Pittsfield, IL 62363 Phone: 217-285-9447 Fax: 217-285-9448 | |
Pike County Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1073 W Washington St, Pittsfield, IL 62363 Phone: 217-285-9661 Fax: 217-285-4641 |