OrganizationActive
Board of Trustees of Southern Illinois University
NPI 1518343722 · Federally Qualified Health Center (FQHC) · Springfield, IL
Provider details
- NPI number
- 1518343722
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Iris Wesley, Ceo/Fqhc Director(217) 545-8000
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
5220 S 6th Street Rd
Suite 1500
Springfield, IL 62703-5735
Phone: (217) 545-8000
Fax: (217) 747-1351
Street-level locationGet directions
Mailing address
Po Box 19670
Springfield, IL 62794-9670
Other names (DBA / former)
- Doing business as
- Siu Center for Family Medicine - Noll
Registry dates
- Enumerated
- 2015-08-11
- Last updated
- 2015-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.