NPIMap

Organization Active NPI

Southern Illinois Health Care Foundation, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Saint Louis, IL
National Provider Identifier
1942510508
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.
Practice address
505 S 8TH St
East Saint Louis, IL 62201
Phone
(618) 332-0953
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X IL
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Federally Qualified Health Center (FQHC) 261QF0400X IL Primary

Addresses

Primary practice location

505 S 8TH St
East Saint Louis, IL 62201

Mailing address

2041 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 332-0953

Other names 2

  • Comprehensive Health Center Doing business as
  • SIHF Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 781891

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 18, 2017
Last certification
Oct 18, 2017
Ownership / control type
For profit – corporation
Facility address
505 South 8TH Street
E St Louis, IL 62201

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1942510508",
    "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": "505 S 8TH ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "62201",
            "telephone_number": "618-332-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2018-08-16",
        "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": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SIHF Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Saint Louis, IL

Sources for this page

Verify at the official NPI Registry.