EASTERN ILLINOIS UNIVERSITY HEALTH SERVICE (NPI# 1104030790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104030790 |
| Entity Type | Organization |
| Organization Name | EASTERN ILLINOIS UNIVERSITY HEALTH SERVICE |
| Practice Address |
600 Lincoln Ave Eastern Illinois University Charleston IL 61920-3011 |
| Practice Telephone | 2175813015 |
| Practice Fax Number | 2175813899 |
| Mailing Telephone | 2175813015 |
| Mailing Fax Number | 2175813899 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SHEILA D BAKER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2175813015 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
E9988478107 | IL | Ambulatory Health Care Facilities |
| Street Address |
600 LINCOLN AVE EASTERN ILLINOIS UNIVERSITY |
| City | CHARLESTON |
| State | IL |
| Zip Code | 61920-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891786950 | Sheila Denise Baker | Family Medicine | 600 Lincoln Ave, Eastern Illinois University, Charleston, IL 61920-3011 | 2005-10-28 |
| 1245855337 | Allison Bertrand | Student in an Organized Health Care Education/Training Program | 600 Lincoln Ave, Charleston, IL 61920-3011 | 2020-06-15 |
| 1053936419 | Hannah Crowley | Speech-Language Pathologist | 600 Lincoln Ave, Charleston, IL 61920-3011 | 2020-06-11 |
| 1992320352 | Emily Lauren Rossetto | Student in an Organized Health Care Education/Training Program | 600 Lincoln Ave, Charleston, IL 61920-3011 | 2020-06-11 |
| 1245855881 | Paige Julia Goesel | Student in an Organized Health Care Education/Training Program | 600 Lincoln Ave, Charleston, IL 61920-3099 | 2020-06-09 |
| 1427673219 | David Kameron Browning | Speech-Language Pathologist | 600 Lincoln Ave, Charleston, IL 61920-3011 | 2020-06-08 |
| 1922621382 | Jill Kathleen Fahy | Speech-Language Pathologist | 600 Lincoln Ave, Charleston, IL 61920-3099 | 2020-05-20 |
| 1366933228 | Becky K Ogle | Nurse Practitioner | 600 Lincoln Ave, Charleston, IL 61920-3099 | 2018-05-25 |
| 1003321589 | Jehan Ayap | Specialist/Technologist | 600 Lincoln Ave, Charleston, IL 61920-3011 | 2017-12-06 |
| 1093241887 | Michaela Elizabeth Desantis | Specialist/Technologist | 600 Lincoln Ave, Charleston, IL 61920-3011 | 2017-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
| 1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
| 1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
| 1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
| 1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
| 1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
| Find all providers in zip 61920 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669950903 | Medical University of South Carolina | Clinic/Center | 30 Bee St Ste 102, Charleston, SC 29425-8910 | 2018-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811409196 | Gavin School District 37 | Clinic/Center | 25775 W Highway 134, Ingleside, IL 60041-9587 | 2017-10-26 |
| 1053822080 | Northestern Illinois University Student Health Services | Clinic/Center | 5500 N Saint Louis Ave Rm E-051, Chicago, IL 60625-4625 | 2017-10-17 |
| 1871905190 | The Board of Trustees of The University of Illinois | Clinic/Center | 840 Blackhawk Blvd, South Beloit, IL 61080-2263 | 2014-05-21 |
| 1043630098 | Mcgaw Medical Center of Northwestern University | Clinic/Center | 240 E. Huron Street, Mcgaw Pavilion, Sutie 1-200, Chicago, IL 60611 | 2014-04-17 |
| 1407284664 | Pef Clinic II, Ltd. | Clinic/Center | 1955 E 75th St, Chicago, IL 60649-3688 | 2013-10-28 |
| 1508294091 | South Shore School of Leadership Health Center | Clinic/Center | 7627 S Constance Ave, Chicago, IL 60649-4009 | 2013-10-22 |
| 1659705150 | Circle Family Healthcare Network | Clinic/Center | 4701 Harrison St, Hillside, IL 60162-1616 | 2013-09-03 |
| 1932441946 | The Board of Trustees of Siu Governing Siue | Clinic/Center | Student Success Ctr Rm 0222, Campus Box 1055, Edwardsville, IL 62026-1055 | 2013-03-18 |
| 1225378094 | Kankakee School District 111 | Clinic/Center | 1200 W Jeffery St, Kankakee, IL 60901-4667 | 2013-02-15 |
| 1033478383 | Rockford School District | Clinic/Center | 401 N Gardiner Ave, Rockford, IL 61107-4338 | 2012-05-07 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 61920 |
Please comment or provide details below to improve the information on EASTERN ILLINOIS UNIVERSITY HEALTH SERVICE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.