Illini Family Medicine

LBN: Southern Illinois Healthcare Foundation, Inc.
Illini Family Medicine is an health care organization with primary practice located at 2900 Frank Scott Pkwy W Suite 980, Belleville IL 62223-5000. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Southern Illinois Healthcare Foundation, Inc. can be contacted via phone (618) 397-3303, or through Mcculley, Larry via phone (618) 332-0694.

Contact Information

Primary practice address
2900 Frank Scott Pkwy W Suite 980 Belleville IL 62223-5000
Phone: (618) 397-3303
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mcculley, Larry
Phone: (618) 332-0694

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Illinois

Profile Details

NPI number 1255880647
LBN Legal business name Southern Illinois Healthcare Foundation, Inc.
DBA Doing business as Illini Family Medicine
Authorized official Mcculley, Larry
Entity Organization
Organization subpart 1 No
Enumeration date Sep 26th, 2016
Last updated Sep 26th, 2016 - about 9 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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