DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

MEDICARE: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
22084P0800XPsychiatry Physician
3261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1659552354
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Provider Business Mailing Address
First Line : 8080 STATE ST
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62203-1808
Country : US
Telephone Number : 618-397-3303
Fax Number : 618-397-7802
Provider Business Practice Location Address
First Line : 50 NORTHGATE INDUSTRIAL DR
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-6805
Country : US
Telephone Number : 618-397-3303
Fax Number : 618-397-7802
Authorized Official
Title or Position : COO
Name : MR. LARRY MCCULLEY
Credential :
Telephone Number : 618-332-0694
Provider Enumeration Date : 11/21/2007
Last Update Date : 04/20/2008

Similar Medicare Providers

1558931030 — ELLEN D HUESGEN LCPC
Practice Location Address:
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL
62040-6805
Practice Phone: 618-877-4420
Practice Fax:
1619921665 — CHESTNUT HEALTH SYSTEMS INC
Practice Location Address:
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL
62040-6805
Practice Phone: 618-877-4420
Practice Fax: 618-877-0904
1740329374 — MRS. ROBERTA JUNE HUGHES APN
Practice Location Address:
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL
62040-6805
Practice Phone: 618-877-4420
Practice Fax: 618-877-9526
1215060942 — MS. PATRICIA ANN NORTHCUTT LCSW
Practice Location Address:
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL
62040-6805
Practice Phone: 618-877-4420
Practice Fax: 618-877-9250
1295855310 — LINDA HYLLA LCSW
Practice Location Address:
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL
62040-6805
Practice Phone: 618-877-4420
Practice Fax:
1548453277 — MS. STEPHANIE D. SEATON
Practice Location Address:
50 NORTHGATE INDUSTRIAL DR
GRANITE CITY, IL
62040-6805
Practice Phone: 618-877-4420
Practice Fax:

Directions to “SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.