BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

NPI # 

Practice Address:

2833 S Grand Ave E

Springfield, IL, 62703-2175

Practice Phone:

221-753-5310

Practice Fax:

217-789-2069

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X