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BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
NPI 1023585312
Clinic/Center - Federally Qualified Health Center (FQHC) in Springfield, IL

Active since October 25, 2018
2833 S GRAND AVE E, SPRINGFIELD, IL 62703(221) 753-5310(217) 789-2069 Get Directions Write a Review

NPPES record last updated: October 25, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Board Of Trustees Of Southern Illinois University NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY (NPI 1023585312), doing business as Siu Center For Family Medicine - Sangamon County Health Mobile Unit, is a healthcare organization registered as a federally qualified health center (fqhc) in Springfield, Illinois and active in the NPI registry since October 2018. The organization lists Iris Wesley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1023585312
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameBOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Location Address2833 S GRAND AVE ESpringfield, IL 62703-2175
Mailing AddressPo Box 19670Springfield, IL 62794-9670 · (217) 535-3102 · Fax (217) 789-2069
Phone(221) 753-5310
Fax(217) 789-2069
Organization SubpartYes
Authorized OfficialIris WesleyCeo · (217) 545-8000
Enumeration DateOctober 25, 2018
✔ NPI 1023585312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
2833 S GRAND AVE E, Springfield, IL 62703
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Other Names 1

Doing Business AsSiu Center For Family Medicine - Sangamon County Health Mobile Unit

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA NICOLE TEYIM
Nurse Practitioner (Family)
2833 S GRAND AVE E
SPRINGFIELD, IL 62703
Sangamon County (217) 535-3100
COUNTY OF SANGAMON
Public Health or Welfare
2833 S GRAND AVE E
SPRINGFIELD, IL 62703
Sangamon County (217) 535-3100
CHILD AND FAMILY CONNECTIONS #18
Case Management
2833 S GRAND AVE E
SPRINGFIELD, IL 62703
Sangamon County (217) 535-3100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Board Of Trustees Of Southern Illinois University's NPI number?

The NPI number for Board Of Trustees Of Southern Illinois University is 1023585312. It was assigned to this organization in the NPPES registry on October 25, 2018. The provider is doing business as SIU Center for Family Medicine - Sangamon County Health Mobile Unit.

Where is Board Of Trustees Of Southern Illinois University located?

Board Of Trustees Of Southern Illinois University is located at 2833 S Grand Ave E, Springfield, IL 62703. The listed phone number is (221) 753-5310.

What is Board Of Trustees Of Southern Illinois University's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Board Of Trustees Of Southern Illinois University was last updated on October 25, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.