| Siu Quincy Family Medicine | |
|
612 N 11th St Quincy IL 62301-2662 | |
| (217) 224-9484 | |
| (217) 224-7950 |
| Full Name | Siu Quincy Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 612 N 11th St, Quincy, Illinois |
| Authorized Official Name and Position | Iris Wesley (CEO) |
| Authorized Official Contact | 2177578000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siu Quincy Family Medicine 612 N 11th St Quincy IL 62301-2662 Ph: (217) 224-9484 | Siu Quincy Family Medicine 612 N 11th St Quincy IL 62301-2662 Ph: (217) 224-9484 |
| NPI Number | 1376921924 |
|---|---|
| Provider Enumeration Date | 05/15/2015 |
| Last Update Date | 08/13/2015 |
| Medicare PECOS PAC ID | 4486667888 |
|---|---|
| Medicare Enrollment ID | O20150831000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376921924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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