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SIU CENTER FOR FAMILY MEDICINE - CARBONDALE
NPI 1437708674
Clinic/Center - Federally Qualified Health Center (FQHC) in Carbondale, IL

Active since September 10, 2019
300 W OAK ST, CARBONDALE, IL 62901(618) 536-6621(618) 453-1102 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 9, 2025, Sep 10, 2019 (2 updates tracked since 2019).

About Siu Center For Family Medicine - Carbondale NPPES

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

SIU CENTER FOR FAMILY MEDICINE - CARBONDALE (NPI 1437708674) is a healthcare organization registered as a federally qualified health center (fqhc) in Carbondale, Illinois and active in the NPI registry since September 2019. The organization lists Iris Wesley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1437708674
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameBOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Location Address300 W OAK STCarbondale, IL 62901-1400
Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-7578
Phone(618) 536-6621
Fax(618) 453-1102
Organization SubpartYes
Authorized OfficialIris WesleyCeo · (217) 545-8000
Enumeration DateSeptember 10, 2019
Last NPPES UpdateJanuary 9, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2025
✔ NPI 1437708674 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
300 W OAK ST, Carbondale, IL 62901
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Other Names 1

Doing Business AsSiu Center For Family Medicine - Carbondale

Other Providers at the Same Location NPPES 20

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

JOELI GEBHART PAC
Physician Assistant
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (618) 536-6621
OLIVIA DOUTHITT PA
Physician Assistant
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (618) 536-6621
EMILY ANN BERRY PA-C
Physician Assistant
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (618) 536-6621
DOMINIC DWAYNE JOHNSON
Community Health Worker
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (217) 891-9662
BRIAN JAY REACH M.D.
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (217) 545-8000
PRECIOUS CHARISSE GAHOL MD
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (618) 536-0221
MARYANN HANNA SABA MD
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (618) 536-6621
WENDY THEIN MYINT
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Jackson County (618) 536-6621

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 1437708674. It was assigned to this organization in the NPPES registry on September 10, 2019. The provider is doing business as Siu Center For Family Medicine - Carbondale.

Where is Board Of Trustees Of Southern Illinois University located?

Board Of Trustees Of Southern Illinois University is located at 300 W Oak St, Carbondale, IL 62901. The listed phone number is (618) 536-6621.

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 January 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.