Board of Trustees of Southern Illinois University
NPI 1407376338 · Federally Qualified Health Center (FQHC) · Decatur, IL
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1407376338
- 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, Chief Executive Officer(217) 545-7876
Specialties & taxonomies
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
Mailing address
Other names (DBA / former)
- Doing business as
- Siu Center for Family Medicine - Decatur
Registry dates
- Enumerated
- 2017-06-21
- 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.