Belleville Pediatric & Adolescent Health Center

LBN: Southern Illinois Healthcare Foundation, Inc.
Belleville Pediatric & Adolescent Health Center is an health care organization with primary practice located at 2900 Frank Scott Pkwy W Suite 950, Belleville IL 62223-5000. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Pediatrics, 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) 233-3205, or through Mcculley, Larry via phone (618) 332-0694.

Contact Information

Primary practice address
2900 Frank Scott Pkwy W Suite 950 Belleville IL 62223-5000
Phone: (618) 233-3205
Fax: (618) 233-1407
Website:
Map and Directions
Authorized official contact:
Name: Mcculley, Larry
Phone: (618) 332-0694

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1376588871
LBN Legal business name Southern Illinois Healthcare Foundation, Inc.
DBA Doing business as Belleville Pediatric & Adolescent Health Center
Authorized official Mcculley, Larry
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2006
Last updated Aug 8th, 2014 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1376588871 NPPES
Illinois Other 732740 WPS MEDICARE

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