OrganizationActive
Board of Trustees of Southern Illinois University
NPI 1184494619 · Federally Qualified Health Center (FQHC) · Springfield, IL
Provider details
- NPI number
- 1184494619
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Board of Trustees of Southern Illinois University
- Organization subpart
- Yes
- Authorized official
- Iris Wesley, Ceo(217) 757-8137
Specialties & taxonomies
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3220 Atlanta St Ste 100
Springfield, IL 62707-8801
Phone: (217) 545-4968
Fax: (217) 545-4444
Street-level locationGet directions
Mailing address
Po Box 19639
Springfield, IL 62794-9639
Other names (DBA / former)
- Doing business as
- Siu Medicine North Dirksen Express Care
- Doing business as
- Siu Medicine North Dirksen Express Care
Registry dates
- Enumerated
- 2024-01-05
- Last updated
- 2025-01-09
- Certified
- 2025-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.