Siu Center For Family Medicine - Decatur

LBN: Board Of Trustees Of Southern Illinois University
Siu Center For Family Medicine - Decatur is an health care organization with primary practice located at 102 W Kenwood Ave , Decatur IL 62526-4368. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Board Of Trustees Of Southern Illinois University can be contacted via phone (217) 872-3800, or through Wesley, Iris via phone (217) 545-7876.

Contact Information

Primary practice address
102 W Kenwood Ave Decatur IL 62526-4368
Phone: (217) 872-3800
Fax: (217) 872-0849
Website:
Map and Directions
Authorized official contact:
Name: Wesley, Iris
Phone: (217) 545-7876

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Illinois

Profile Details

NPI number 1407376338
LBN Legal business name Board Of Trustees Of Southern Illinois University
DBA Doing business as Siu Center For Family Medicine - Decatur
Authorized official Wesley, Iris
Entity Organization
Organization subpart 1 No
Enumeration date Jun 21st, 2017
Last updated Jun 21st, 2017 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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