SIU CENTER FOR FAMILY MEDICINE - DECATUR
NPI 1407376338
Clinic/Center - Federally Qualified Health Center (FQHC) in Decatur, IL
NPI Status: Active since June 21, 2017
Contact Information
102 W KENWOOD AVE
DECATUR, IL
ZIP 62526
Phone: (217) 872-3800
Fax: (217) 872-0849
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 14D0435205
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-31-2026
About SIU CENTER FOR FAMILY MEDICINE - DECATUR
This page provides the complete NPI Profile along with additional information for Siu Center For Family Medicine - Decatur, a primary care provider established in Decatur, Illinois operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1407376338 assigned on June 2017. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Siu Center For Family Medicine - Decatur. The authorized official of this NPI record is Iris Wesley (Chief Executive Officer)
- NPI
- 1407376338
- Provider Legal Name
- BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
- Other Organization Name
- SIU CENTER FOR FAMILY MEDICINE - DECATUR
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 102 W KENWOOD AVE DECATUR, IL 62526
- Location Phone
- (217) 872-3800
- Location Fax
- (217) 872-0849
- Mailing Address
- PO BOX 19639 SPRINGFIELD, IL 62794
- Mailing Phone
- (217) 872-3800
- Mailing Fax
- (217) 872-0849
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-21-2017
- Last Update Date
- 01-09-2025
- Code Navigator
A primary care provider (PCP) like Siu Center For Family Medicine - Decatur sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
- License State
- IL
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0435205
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- ETHAN P. BERRY
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Siu Center For Family Medicine - Decatur in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1407376338, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DECATUR, IL 62526
DECATUR, IL 62526
DACATUR, IL 62526
DECATUR, IL 62526
DECATUR, IL 62526
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407376338, enumerated as an "organization" on June 21, 2017.
The provider is located at 102 W KENWOOD AVE DECATUR, IL 62526 and the phone number is (217) 872-3800.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
