KOCH HEALTH CENTER
NPI 1801822010
Clinic/Center - Federally Qualified Health Center (FQHC) in Granite City, IL

Q: What is Southern Illinois Healthcare Foundation, Inc'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 June 23, 2006

2100 MADISON AVE, GRANITE CITY, IL 62040(618) 452-3301(618) 452-3312 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Koch Health Center NPPES

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

KOCH HEALTH CENTER (NPI 1801822010) is a healthcare organization registered as a federally qualified health center (fqhc) in Granite City, Illinois and active in the NPI registry since June 2006. The organization lists Larry Mcculley, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1801822010

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameSOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC

Location Address2100 MADISON AVEGranite City, IL 62040-4701

Mailing Address8080 State StEast Saint Louis, IL 62203-1808 · (618) 397-3303 · Fax (618) 397-7802

Phone(618) 452-3301

Fax(618) 452-3312

Organization SubpartNo

Authorized OfficialLarry McculleyChief Operating Officer · (618) 332-0783

Enumeration DateJune 23, 2006

Last NPPES UpdateApril 20, 2008

✔ NPI 1801822010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedPediatricsTaxonomy 208000000X

2100 MADISON AVE, Granite City, IL 62040

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Other Names 1

Doing Business AsKoch Health Center

Other Identifiers 3

Medicare ID-Type Unspecified141930IL

Other732740IL · Wps Medicare Group Number

Medicaid=========026IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Koch Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

164

Medicare enrollment records show 164 clinicians reassign Medicare billing to Koch Health Center, which bills Medicare for the services they deliver. Of these, 42 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 15

Nurse Practitioner57

Family Practice43

Internal Medicine16

Psychiatry12

Clinical Social Worker9

Mental Health Counselor6

Obstetrics/Gynecology5

Cardiovascular Disease (Cardiology)3

7 other specialties13

Nearest to this location (20)

See all 164

James Fernandez, M.D.

Otolaryngology

NPI 1528037280

2120 MADISON AVE SUITE 200
Granite City, IL 62040

(618) 451-1800

✔ PECOS✔ Accepts Medicare0.1 mi

Oladele Ajao, MD

Internal Medicine

NPI 1700829025

2100 MADISON AVE
Granite City, IL 62040

(618) 452-3301

✔ PECOS✔ Accepts Medicare0.1 mi

Sang Nelson, LCSW

Clinical Social Worker

NPI 1821177056

2100 MADISON AVE STE. 303
Granite City, IL 62040

(618) 452-4969

✔ PECOS0.1 mi

Michael Adams, MD

Internal Medicine

NPI 1851383301