SIU CENTER FOR FAMILY MEDICINE - GIM SALVATION ARMY
NPI 1770259764
Clinic/Center - Federally Qualified Health Center (FQHC) in Springfield, IL

Q: 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.

Active since August 19, 2021

1600 E CLEAR LAKE AVE STE 120, SPRINGFIELD, IL 62703(217) 545-8000 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, Aug 19, 2021 (2 updates tracked since 2021).

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About Siu Center For Family Medicine - Gim Salvation Army NPPES

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

SIU CENTER FOR FAMILY MEDICINE - GIM SALVATION ARMY (NPI 1770259764) is a healthcare organization registered as a federally qualified health center (fqhc) in Springfield, Illinois and active in the NPI registry since August 2021. The organization lists Iris Wesley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1770259764

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameBOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

Location Address1600 E CLEAR LAKE AVE STE 120Springfield, IL 62703-1172

Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-6523

Phone(217) 545-8000

Organization SubpartYes

Authorized OfficialIris WesleyCeo · (217) 545-8000

Enumeration DateAugust 19, 2021

Last NPPES UpdateJanuary 9, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 9, 2025

✔ NPI 1770259764 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

1600 E CLEAR LAKE AVE STE 120, Springfield, IL 62703

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Other Names 1

Doing Business AsSiu Center For Family Medicine - Gim Salvation Army

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 1770259764. It was assigned to this organization in the NPPES registry on August 19, 2021. The provider is doing business as Siu Center For Family Medicine - Gim Salvation Army.

Where is Board Of Trustees Of Southern Illinois University located?

Board Of Trustees Of Southern Illinois University is located at 1600 E Clear Lake Ave Ste 120, Springfield, IL 62703. The listed phone number is (217) 545-8000.

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 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.