Public record

CMS Federally Qualified Health Center All Owners

Associate id - owner: 6204731490 · 37 matching records

Enrollment id
O20060208000832
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20071227000556
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2008-01-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20081029000867
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20081029000897
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20081029000941
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20081029000945
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20081029000949
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20081030000237
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20081030000255
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20090326000134
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20090708000671
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20090716000602
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20100311000882
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20110311000451
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20110420000436
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20120220000066
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20120806000072
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20121120000102
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20130308000481
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20140422000002
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20140820001464
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20160420001731
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20161018001776
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20170425000282
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Enrollment id
O20170913000810
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
BOARD OF DIRECTORS
Percentage ownership
0
Enrollment id
O20171026001503
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Title - owner
CHAIRPERSON
Percentage ownership
0
Enrollment id
O20171026001706
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-05-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20230206001728
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20240322002923
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20240410001472
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20240416002738
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20240805000037
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20240925002886
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20241207000017
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2024-12-16
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20260612000103
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20260625003129
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER
Enrollment id
O20260903000253
Associate id
1456256874
Organization name
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner
6204731490
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
1996-04-01
First name - owner
ETHEL
Last name - owner
MANAGER

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