Southern Illinois Healthcare Foundation, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

Doing business as

Sihf Madison Recovery Facility

Practice address

648 State St
Madison, IL 62060-1420

Phone

(618) 397-3303

Fax

(618) 397-7802

NPI assigned

Oct 29, 2007

Last updated

Oct 29, 2007By the provider in NPPES

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

Coo

Phone

(618) 332-0694

Specialties & licenses 3

Addresses

Other names 1

• SIHF MADISON RECOVERY FACILITY Doing business as

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1316126147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 STATE ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622031808",
            "telephone_number": "618-397-3303",
            "fax_number": "618-397-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 STATE ST",
            "city": "MADISON",
            "state": "IL",
            "postal_code": "620601420",
            "telephone_number": "618-397-3303",
            "fax_number": "618-397-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "MCCULLEY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "618-332-0694",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIHF MADISON RECOVERY FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason F. Kesselring, MD
• Madison County Urban League
• Real RN Recruiter (Wellness Psychiatry)
• Rachelle Russell
• Southern Illinois Healthcare Foundation, Inc. (Madison Health Center)
• Southern Illinois Healthcare Foundation, Inc. (Sihf Madison Resolution Faclty)
• Stay at Home Health Care Inc
• Renee M Titley

• Federally Qualified Health Center (FQHC) in Madison, IL
• Providers in Madison, 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 Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.