Southern Illinois Health Care Foundation, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.

Doing business as

Comprehensive Health Center
SIHF Healthcare

Practice address

505 S 8TH St
East Saint Louis, IL 62201

Phone

(618) 332-0953

NPI assigned

Oct 18, 2010

Last updated

Aug 16, 2018By 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 5

Addresses

Other names 2

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942510508. Details of each certification follow.

• CCN 781891 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 781891

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

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"
        }
    ]
}

• Erin Deneen Sanders
• Charles Scheer, NP
• Bharat Kantilal Shah, M.D.
• Tierra Q Smith, FNP-BC
• Southern Illinois Health Care Foundation, Inc. (SIHF Healthcare)
• Southern Illinois Healthcare Foundation Inc (Christian Activity Health Center)
• Southern Illinois Healthcare Foundation, Inc. (Quick Care I Center)
• Southern Illinois Healthcare Foundation, Inc. (Adult Care Center)
• Southern Illinois Healthcare Foundation, Inc. (SIHF Healthcare)
• Southern Illinois Healthcare Foundation, Inc. (Fairmont City Health Center)

• 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 Aug 16, 2018; 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.