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SIU MEDICINE NORTH DIRKSEN EXPRESS CARE
NPI 1184494619
Clinic/Center - Federally Qualified Health Center (FQHC) in Springfield, IL

Active since January 05, 2024CLIA Certified · 2 labs
3220 ATLANTA ST STE 100, SPRINGFIELD, IL 62707(217) 545-4968(217) 545-4444 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 9, 2025, Jul 1, 2024, Jan 5, 2024 (3 updates tracked since 2024).

About Siu Medicine North Dirksen Express Care NPPES

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

SIU MEDICINE NORTH DIRKSEN EXPRESS CARE (NPI 1184494619) is a healthcare organization registered as a federally qualified health center (fqhc) in Springfield, Illinois and active in the NPI registry since January 2024. The organization holds 2 active CLIA laboratory certificates and lists Iris Wesley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1184494619
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameBOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Location Address3220 ATLANTA ST STE 100Springfield, IL 62707-8801
Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000 · Fax (844) 470-2488
Phone(217) 545-4968
Fax(217) 545-4444
Organization SubpartYes
Authorized OfficialIris WesleyCeo · (217) 757-8137
Enumeration DateJanuary 5, 2024
Last NPPES UpdateJanuary 9, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2025
✔ NPI 1184494619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
3220 ATLANTA ST STE 100, Springfield, IL 62707
Open in Google Maps ↗

Other Names 1

Doing Business AsSiu Medicine North Dirksen Express Care

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2285209

Siu Medicine · Springfield, IL
Active · expires Jul 7, 2027
CLIA Number14D2285209
Laboratory TypePhysician Office
Certificate Effective DateJuly 8, 2025
Certificate Expiration DateJuly 7, 2027
Laboratory DirectorMichael Jakoby
Laboratory Phone(217) 545-8000
Laboratory LocationSiu Medicine751 N Rutledge - Ste 1700, Springfield, IL 62702
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2299957

Siu Medical Express Care - North Dirksen · Springfield, IL
Active · expires Feb 28, 2028
CLIA Number14D2299957
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 28, 2026
Certificate Expiration DateFebruary 28, 2028
Laboratory DirectorMichal Dynda
Laboratory Phone(217) 545-8000
Laboratory LocationSiu Medical Express Care - North Dirksen3220 Atlantic St, Springfield, IL 62707
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

DR. BENJAMIN E. MONTGOMERY M.D.
Family Medicine
3220 ATLANTA ST STE 100
SPRINGFIELD, IL 62707
Sangamon County (217) 545-8801
JORDEN GENTRY PA-C
Physician Assistant
3220 ATLANTA ST STE 100
SPRINGFIELD, IL 62707
Sangamon County (217) 545-4968
KARA MICHELLE FELLERS APRN
Nurse Practitioner (Family)
3220 ATLANTA ST STE 100
SPRINGFIELD, IL 62707
Sangamon County (217) 545-4968

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 1184494619. It was assigned to this organization in the NPPES registry on January 5, 2024. The provider is doing business as Siu Medicine North Dirksen Express Care.

Where is Board Of Trustees Of Southern Illinois University located?

Board Of Trustees Of Southern Illinois University is located at 3220 Atlanta St Ste 100, Springfield, IL 62707. The listed phone number is (217) 545-4968.

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.

Does Board Of Trustees Of Southern Illinois University hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Board Of Trustees Of Southern Illinois University was last updated on January 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.