Southern Illinois Healthcare Foundation, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

Practice address

824 Locust St
Red Bud, IL 62278-1209

Phone

(618) 282-6656

NPI assigned

Apr 5, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Larry McCulley

Title

President/Ceo

Phone

(618) 332-0694

Specialties & licenses 3

Addresses

Other names 2

• SIHF Healthcare Doing business as
• SIHF Healthcare - Red Bud Other name

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 781852

Legal name

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 5, 2016

Last certification

May 5, 2016

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Sep 27, 1985 in IL

Enrollment address

824 Locust St
Red Bud, IL 62278-1209

Locations

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mikasa L Crawford, FNP

  • Family Nurse Practitioner
  • Springfield, IL
  • NPI 1316486160
  NPD
• Janis Deann Miller, NP

  • Nurse Practitioner
  • Greenup, IL
  • NPI 1356401335

  Family

  NPD
• Roberta Cheryl Pritchard-Palmer, APRN,BC

  • Family Nurse Practitioner
  • Belleville, IL
  • NPI 1518130707
  NPD
• Sarah Rahman, PA-C

  • Physician Assistant
  • Cahokia, IL
  • NPI 1518391739
  NPD
• Kenneth G. Reinert, M.D.

  • Family Medicine Physician
  • O Fallon, IL
  • NPI 1295781607
  NPD
• Matthew Brian Wilkinson, M.D.

  • Internal Medicine Physician
  • Overland, MO
  • NPI 1821083866
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1033573183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GOOSE LAKE RD",
            "city": "SAUGET",
            "state": "IL",
            "postal_code": "622062822",
            "telephone_number": "618-332-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 LOCUST ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781209",
            "telephone_number": "618-282-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "MCCULLEY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "618-332-0694",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIHF Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SIHF Healthcare - Red Bud",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angela Katherine Schloer, FNP
• Lauren Scovill
• Amanda Shoemaker
• Stacy A Slavens, MOTRL
• Jade South, LSW
• Stenzel Chiropractic
• Stenzel Chiropractic, LLC
• Quentin Richard Stenzel, D.C.
• Quentin Thomas Stenzel, D.C.
• Stillwell Health PLLC

• Federally Qualified Health Center (FQHC) in Red Bud, IL
• Providers in Red Bud, IL by specialty
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.