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SOUTHERN ILLINOIS FAMILY FOOT CARE, LLC
NPI 1972843613
Clinic/Center - Medical Specialty in Mount Vernon, IL

Active since February 17, 2013CLIA 14D0436282 · Waiver
221 N 27TH ST, MOUNT VERNON, IL 62864(618) 244-3668 Get Directions Write a Review

NPPES record last updated: May 16, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Illinois Family Foot Care, Llc NPPES

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

SOUTHERN ILLINOIS FAMILY FOOT CARE, LLC (NPI 1972843613) is a healthcare organization registered as a medical specialty in Mount Vernon, Illinois and active in the NPI registry since February 2013. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Brian Lee, President, as its authorized official.

NPPES Registry Identity

NPI1972843613
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameSOUTHERN ILLINOIS FAMILY FOOT CARE, LLC
Location Address221 N 27TH STMount Vernon, IL 62864-2941
Mailing Address221 N 27th StMount Vernon, IL 62864-2941 · (618) 244-3668
Phone(618) 244-3668
Organization SubpartNo
Authorized OfficialBrian LeePresident · (618) 244-3668
Enumeration DateFebruary 17, 2013
Last NPPES UpdateMay 16, 2014
✔ NPI 1972843613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in IL · 016003846
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
221 N 27TH ST, Mount Vernon, IL 62864
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Other Identifiers 2

Medicare UPINT38663IL
Medicaid1285744060IL

CLIA Laboratory Certificates CMS CLIA

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 14D0436282

Southern Illinois Family Foot · Mount Vernon, IL
Active · expires Aug 31, 2026
CLIA Number14D0436282
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorBrian R. Lee Do
Laboratory Phone(618) 244-3668
Laboratory LocationSouthern Illinois Family Foot221 N 27th Street, Mount Vernon, IL 62864
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Southern Illinois Family Foot Care, LLC's NPI number?

The NPI number for Southern Illinois Family Foot Care, LLC is 1972843613. It was assigned to this organization in the NPPES registry on February 17, 2013.

Where is Southern Illinois Family Foot Care, LLC located?

Southern Illinois Family Foot Care, LLC is located at 221 N 27th St, Mount Vernon, IL 62864. The listed phone number is (618) 244-3668.

What is Southern Illinois Family Foot Care, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Southern Illinois Family Foot Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0436282) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Illinois Family Foot Care, LLC was last updated on May 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.