OrganizationActive
Board of Trustees of Southern Illinois University
NPI 1396097960 · Primary Care Clinic/Center · Springfield, IL
Provider details
- NPI number
- 1396097960
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Iris Wesley, Ceo(217) 545-8000
Specialties & taxonomies
Ambulatory Health Care Facilities
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
520 N 4th St
Springfield, IL 62702-5238
Phone: (217) 757-8100
Fax: (217) 747-1351
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 19639
Springfield, IL 62794-9639
Other names (DBA / former)
- Doing business as
- Siu Center for Family Medicine
- Doing business as
- Siu Center for Family Medicine
Registry dates
- Enumerated
- 2012-10-08
- Last updated
- 2026-04-20
- Certified
- 2026-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.