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

ESL School Based Clinic

Practice address

3939 Caseyville Ave
East Saint Louis, IL 62204-2448

Phone

(618) 482-4562

Fax

(618) 482-4930

NPI assigned

Dec 26, 2006

Last updated

Feb 25, 2013By 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

Ceo

Phone

(618) 332-0694

Specialties & licenses 3

Addresses

Other names 1

• ESL School Based Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Megha Bharat Manek, MD

  • Family Medicine Physician
  • Alton, IL
  • NPI 1841446473
  NPD

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1831254234",
    "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": "3939 CASEYVILLE AVE",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622042448",
            "telephone_number": "618-482-4562",
            "fax_number": "618-482-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2013-02-25",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ESL School Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Illinois Healthcare Foundation, Inc. (Adult Care Center)
• Southern Illinois Healthcare Foundation, Inc. (SIHF Healthcare)
• Southern Illinois Healthcare Foundation, Inc. (Fairmont City Health Center)
• Southern Illinois Healthcare Foundation, Inc. (Windsor Health Center II)
• Southern Illinois Healthcare Foundation, Inc. (State Street Center)
• Southern Illinois Regional Wellness Center
• Southern Illinois University Edwardsville
• Sse Care LLC
• Latisha Trenice Stennis, PMHNP
• Joyce C. Stewart-Borders, CNP

• Federally Qualified Health Center (FQHC) in East Saint Louis, IL
• Providers in East Saint Louis, 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 Feb 25, 2013; 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.