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

2810 Frank Scott Pkwy W
Belleville, IL 62223-5007

Phone

(618) 236-6336

Fax

(618) 236-9582

NPI assigned

Apr 21, 2011

Organization subpart

No

Name

Mr. Larry McCulley

Title

Ceo

Phone

(618) 332-0694

Organizations listed as members of this organization in the National Provider Directory.

• Touchette Regional Hospital Inc

  • Emergency Medicine Physician
  • Cahokia Heights, IL
  • NPI 1922019926

  Member Of

  NPD member

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

• Jacqueline S. Aregood, MD

  • Psychiatry Physician
  • Belleville, IL
  • NPI 1154302115
  NPD
• Benjamin Carl Beggs, MD

  • Family Medicine Physician
  • O Fallon, IL
  • NPI 1386174381
  NPD
• Janel L. Clark, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Granite City, IL
  • NPI 1578951752
  NPD
• Andrew M Gaillardetz, MD

  • Family Medicine Physician
  • Shiloh, IL
  • NPI 1548764236
  NPD
• Jamie Hardman, MD

  • Obstetrics & Gynecology Physician
  • Alton, IL
  • NPI 1093060584
  NPD
• Monika Renee Cluney, DO

  • Obstetrics & Gynecology Physician
  • Fontana, CA
  • NPI 1982062923
  NPD

Medicare fee-for-service enrollment

Enrolled in IL

• Children's Medical Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 2, 2011.

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1699066985",
    "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": "618-332-0953",
            "fax_number": "618-332-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-236-6336",
            "fax_number": "618-236-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "MCCULLEY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-332-0694",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Illinois Healthcare Foundation, Inc
• Southern Illinois Healthcare Foundation, Inc.
• Southern Illinois Healthcare Foundation, Inc.
• Southern Illinois Healthcare Foundation, Inc.
• Southern Illinois Healthcare Foundation, Inc.
• Southern Illinois Internal Medicine LTD
• Southern Illinois Neurologic Institute
• Southern Illinois Oral & Maxillofacial Surgery, LTD.
• Southern Illinois Otolaryngology, LTD
• Southern Illinois Physician Services, PC

• All providers in Belleville, IL
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.