SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC – NPI #1679188437
Clinic/Center

SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC is an AHC clinic located in SPRINGFIELD, IL. NPPES has assigned the NPI number 1679188437 to SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC on September 09, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC” is a dba name, the actual legal business name for this organization is BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was last updated on Jan 09, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC below.

NPI Profile for
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

NPI Number
1679188437
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Doing Business As (dba): SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC
Primary location
751 N RUTLEDGE ST STE 1100
SPRINGFIELD, IL 62702-4968
Phone: (217) 545-8000 Fax: (217) 545-4735
1 Other location(s):
747 N Rutledge St Ste 2287-B
Springfield, IL 62702-6700
Phone: (217) 545-8000
Mailing address
PO BOX 19639
SPRINGFIELD, IL 62794-9639
Phone: (217) 545-7876 Fax:
Organization Subpart
Yes - SIU CENTER FOR FAMILY MEDICINE - GENERAL INTERNAL MEDICINE CLINIC is subpart of another organization.
Authorized Official
IRIS WESLEY
CEO
Phone: (217) 545-8000
Updated
Certification Date
Jan 09, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
261QP2300X
- Clinic/Center / Primary Care

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.