Board of Trustees of Southern Illinois University
Federally qualified health center in Decatur, IL, Medicare certification number 781876.
Medicare certification
Provider of Services- CCN
- 781876
- Status
- Active
- Provider type
- Federally qualified health center
- Control type
- For profit – corporation
- Participating since
- Jul 17, 2017
- Last certification
- Jul 17, 2017
- Address
- 102 W Kenwood Ave, Ste 100
Decatur, IL 62526
(217) 872-3800
NPI records for this facility (CCN to NPI Mapping) 1
-
dba SIU Center for Family Medicine - Decatur
- Federally Qualified Health Center (FQHC)
- Decatur, IL
- NPI 1407376338
Medicare enrollment
Sources for this page
- Provider of Services: the certification, provider type, beds and status.
- Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
- NPPES NPI Registry: the NPI records connected to this certification.