| Board Of Trustees Of Southern Illinois University | |
|
109 3rd St Lincoln IL 62656-2604 | |
| (217) 735-2317 | |
| (217) 732-6943 |
| Full Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 3rd St, Lincoln, Illinois |
| Authorized Official Name and Position | Iris Wesley (CEO) |
| Authorized Official Contact | 2175457876 |
| 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) 545-8000 | Board Of Trustees Of Southern Illinois University 109 3rd St Lincoln IL 62656-2604 Ph: (217) 735-2317 |
| NPI Number | 1972049641 |
|---|---|
| Provider Enumeration Date | 01/18/2017 |
| Last Update Date | 01/09/2025 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20170316002207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972049641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Family Medical Center Of Lincoln, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 | |
Healthcare Network Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 | |
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Memorial Physician Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 | |
Springfield Clinic, Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Stahlhut Dr, Lincoln, IL 62656 Phone: 217-735-9555 | |
Abraham Lincoln Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Stahlhut Dr, Lincoln, IL 62656 Phone: 217-732-2161 Fax: 217-735-3526 | |
Memorial Physician Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 N College St, Lincoln, IL 62656 Phone: 217-732-9681 Fax: 217-735-6527 |