| Siu Center For Family Medicine - General Internal Medicine Clinic | |
|
751 N Rutledge St Ste 1100 Springfield IL 62702-4968 | |
| (217) 545-8000 | |
| Not Available |
| Full Name | Siu Center For Family Medicine - General Internal Medicine Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 751 N Rutledge St Ste 1100, Springfield, 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 |
|---|---|
| Siu Center For Family Medicine - General Internal Medicine Clinic Po Box 19639 Springfield IL 62794-9639 Ph: (217) 545-7876 | Siu Center For Family Medicine - General Internal Medicine Clinic 751 N Rutledge St Ste 1100 Springfield IL 62702-4968 Ph: (217) 545-8000 |
| NPI Number | 1679188437 |
|---|---|
| Provider Enumeration Date | 09/09/2020 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20210903000716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679188437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2833 S Grand Ave E, Springfield, IL 62703 Phone: 221-753-5310 Fax: 217-789-2069 | |
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North Dirksen Medical Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3220 Atlanta St, Springfield, IL 62707 Phone: 217-588-7400 | |
Siu Physicians & Surgeons, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 N 1st St, D235, Springfield, IL 62781 Phone: 217-545-7578 Fax: 217-545-1884 | |
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