| Siu Center For Family Medicine | |
|
520 N 4th St Springfield IL 62702-5238 | |
| (217) 545-8000 | |
| (217) 747-1351 |
| Full Name | Siu Center For Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 520 N 4th St, Springfield, Illinois |
| Authorized Official Name and Position | Linda A Toth (AUTHORIZING OFFICIAL) |
| 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 Po Box 19670 Springfield IL 62794-9670 Ph: (217) 545-8000 | Siu Center For Family Medicine 520 N 4th St Springfield IL 62702-5238 Ph: (217) 545-8000 |
| NPI Number | 1497002182 |
|---|---|
| Provider Enumeration Date | 08/13/2012 |
| Last Update Date | 08/13/2015 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20121002000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497002182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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