Southern Illinois Healthcare Foundation Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · East Alton, IL
NPI 1962234070 · NPPES record last updated Aug 16, 2024
Key facts
- NPI
- 1962234070
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
- Practice address
- 2 Terminal Dr Ste 4B
East Alton, IL 62024-2296 - Phone
- (618) 216-8127
- Fax
- (618) 216-8128
- NPI assigned
- Aug 16, 2024
- Organization subpart
- No
Authorized official
- Name
- James F Spinner
- Title
- Sr. Director of Compliance
- Phone
- (618) 332-0953
Corporate family (same tax ID) 37
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL
Federally qualified health center certification: CCN C41032
- Legal name
- SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
- Doing business as
- SIHF HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 4, 2024
- Last certification
- Sep 4, 2024
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 27, 1985 in IL
- Enrollment address
- 2 Terminal Dr
Ste 4B
East Alton, IL 62024-2296
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Walter Hunter |
Corporate Director | Feb 1, 2008 | |
| Gerard Hasenstab |
Corporate Director | Jan 1, 2019 | |
| Dale Fiedler |
Corporate Director | Jan 1, 2020 | |
| Debra Reed |
Corporate Director | Jan 1, 2021 | |
| James F Spinner |
W-2 Managing Employee | Apr 1, 2004 | |
| Larry W McCulley |
Corporate Officer | Feb 1, 2004 | |
| Kenneth Hall |
Corporate Director | Apr 1, 2015 | |
| Zoila Marty |
Corporate Director | Aug 1, 2005 | |
| Ethel Manager |
Corporate Director | Apr 1, 1996 | |
| Anna Marie Nelson |
Corporate Director | Jul 1, 2009 | |
| Richard Sinclair |
Corporate Director | Jul 1, 2006 | |
| Irma Golliday |
Corporate Director | Jul 1, 1999 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Touchette Regional Hospital Inc |
Hospital | Operational/Managerial Control | Jun 30, 2009 |
| Touchette Regional Hospital Inc |
Hospital | Operational/Managerial Control | Jun 30, 2009 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000641 | IL | Part B Supplier - Clinic/Group Practice | 1456256874 |
Receives reassigned benefits from 170 practitioners This NPI is an additional NPI on the enrollment Practice locations: East Saint Louis, IL; Effingham, IL; Fairmont City, IL; Glen Carbon, IL; Granite City, IL; Greenup, IL; Mattoon, IL; Millstadt, IL… |
| O20240925002886 | IL | Part a Provider - Federally Qualified Health Center (FQHC) | 1456256874 | Practice locations: East Alton, IL |
National Provider Directory
- Tax ID family
- Southern Illinois Hthca
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
2 Terminal Dr Ste 4B
East Alton, IL 62024-2296
Mailing address
2041 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 332-0953
Other names
- SIHF Healthcare
Other providers in East Alton, IL
- Rosewood Physical Therapy LTD
- Eric Royal
- Anna Marie Seymour
- Sottoriva Chiropractic
- Charles Henry Sottoriva
- Southern Illinois Healthcare Foundation, Inc.
- Edward Lee St.Peters
- Tad J Steinhauer
- Heather L Strebel
- Christopher Dean Suhre
All providers in East Alton, IL · Federally Qualified Health Center (FQHC) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.