Board of Trustees of Southern Illinois University
NPI 1770259764 · Federally Qualified Health Center (FQHC) · Springfield, IL
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Board of Trustees of Southern Illinois University is a Federally Qualified Health Center (FQHC) organization in Springfield, IL (NPI 1770259764).
Provider details
- NPI number
- 1770259764
- 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) 545-8000
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
4 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 - Gim Salvation Army
Registry dates
- Enumerated
- 2021-08-19
- Last updated
- 2025-01-09
- Certified
- 2025-01-09
Frequently asked questions
- What is Board of Trustees of Southern Illinois University's NPI number?
- Board of Trustees of Southern Illinois University's National Provider Identifier (NPI) is 1770259764, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Board of Trustees of Southern Illinois University?
- Board of Trustees of Southern Illinois University is classified in the NPPES registry as Federally Qualified Health Center (FQHC) (Ambulatory Health Care Facilities).
- Where is Board of Trustees of Southern Illinois University located?
- Board of Trustees of Southern Illinois University's practice location on file with NPPES is 1600 E Clear Lake Ave Ste 120, Springfield, IL 62703-1172.
- What is Board of Trustees of Southern Illinois University's phone number?
- The practice phone number listed in the NPPES registry for Board of Trustees of Southern Illinois University is (217) 545-8000.
- Does Board of Trustees of Southern Illinois University accept Medicare?
- Board of Trustees of Southern Illinois University is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Board of Trustees of Southern Illinois University?
- The authorized official listed on Board of Trustees of Southern Illinois University's NPPES record is Iris Wesley, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Board of Trustees of Southern Illinois University's NPI active?
- Yes — Board of Trustees of Southern Illinois University's NPI (1770259764) is active in the NPPES registry as of the last update on 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.