Board Of Trustees Of Southern Illinois University

LBN: Board Of Trustees Of Southern Illinois University
Board Of Trustees Of Southern Illinois University is an health care organization with primary practice located at 1600 E Clear Lake Ave Ste 120 , Springfield IL 62703-1172. 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) 545-8000, or through Burdick, Shelby Renee via phone (217) 545-6523.

Contact Information

Primary practice address
1600 E Clear Lake Ave Ste 120 Springfield IL 62703-1172
Phone: (217) 545-8000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Burdick, Shelby Renee
Phone: (217) 545-6523

Health care specialties

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

Profile Details

NPI number 1770259764
LBN Legal business name Board Of Trustees Of Southern Illinois University
DBA Doing business as
Authorized official Burdick, Shelby Renee
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 19th, 2021
Last updated Aug 19th, 2021 - about 3 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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