NORTHERN ILLINOIS UNIVERSITY (NPI# 1194991216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194991216 |
| Entity Type | Organization |
| Organization Name | NORTHERN ILLINOIS UNIVERSITY |
| Other Organization Name | NIU PHYSICAL THERAPY CLINIC |
| Practice Address |
3100 Sycamore Rd Dekalb IL 60115-9621 |
| Practice Telephone | 8157522675 |
| Practice Fax Number | 8157536169 |
| Mailing Telephone | 8157522675 |
| Mailing Fax Number | 8157536169 |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2013-07-10 |
| Authorized Official Name | CARISSA NICOLE CALLAHAN (ASSISTANT TO THE DEAN) |
| Authorized Official Telephone | 8157536161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
070012170 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| NIU Physical Therapy Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114237153 | Northern Illinois University | Marriage & Family Therapist | 146 Wirtz Hall, Dekalb, IL 60115-3088 | 2010-10-08 |
| 1982756417 | Northern Illinois University | Clinic/Center | 1 Lucinda Avenue, Northern Illinois University, Dekalb, IL 60115 | 2007-01-17 |
| 1144327487 | Northern Illinois University | Clinic/Center | Kirk and Pine Rd, Batavia, IL 60510 | 2006-09-20 |
| 1700332392 | Northern Illinois University | Pediatrics | 1425 W Lincoln Hwy, Convocation Center, Dekalb, IL 60115-2828 | 2016-09-01 |
| 1780990051 | Northern Illinois University | Clinic/Center | 1525 W Lincoln Hwy, Suite 170-niu Athletic Training, Dekalb, IL 60115-3989 | 2010-08-25 |
| 1205061769 | Northern Illinois University | Speech-Language Pathologist | 3100 Sycamore Road, Niu Speech Language Hearing Clinic, Dekalb, IL 60115-2899 | 2009-05-27 |
| 1225218365 | Northern Illinois University | Clinic/Center | 21193 Malta Rd, Malta, IL 60150-9600 | 2007-11-06 |
| 1407916836 | Northern Illinois University | Speech-Language Pathologist | 3100 Sycamore Rd, Niu Speech Language Hearing Clinic, Dekalb, IL 60115-9621 | 2006-12-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHERN ILLINOIS UNIVERSITY | 1425 W Lincoln Hwy, De Kalb, IL 60115-2828 |
| Street Address |
3100 SYCAMORE RD |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-9621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699791863 | Cynthia Erdos | Audiologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2006-07-14 |
| 1255889762 | In-sop Kim | Speech-Language Pathologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2016-09-13 |
| 1992178990 | Renee Wootton | Speech-Language Pathologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2015-11-12 |
| 1093188088 | Maria Mildred Castillo | Physical Therapist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2015-11-12 |
| 1477924389 | Allison Lynn Gladfelter | Speech-Language Pathologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2015-10-19 |
| 1427429976 | Mariah Cheyney | Audiologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2015-10-09 |
| 1225416605 | Judith Lutz | Speech-Language Pathologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2015-05-18 |
| 1457785933 | Kim Wedoff | Speech-Language Pathologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2013-09-03 |
| 1477810042 | Rebekah F Wagner | Physical Therapist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2012-04-19 |
| 1891052551 | Danai C.f Fannin | Speech-Language Pathologist | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2012-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700295631 | Renew Physical Therapy Inc | Clinic/Center | 123 E Lincoln Hwy, Dekalb, IL 60115-3205 | 2014-08-05 |
| 1821251430 | Northern Illinois University-physical Therapy | Clinic/Center | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2008-07-03 |
| 1568578219 | Us Pt Therapy Services, Inc. | Clinic/Center | 3266 Sycamore Rd, Dekalb, IL 60115-9621 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790336 | Priority You Physical Therapy and Wellness, Pllc | Clinic/Center | 20660 Caton Farm Rd., Unit A, Crest Hills, IL 60403 | 2020-11-03 |
| 1487253464 | Chimera Health Pllc | Clinic/Center | 525 N Ada St Apt 10, Chicago, IL 60642-6486 | 2020-10-21 |
| 1528666468 | Chicago Pelvic Health and Wellness, LLC | Clinic/Center | 1020 E Ogden Ave Ste 309, Naperville, IL 60563-8611 | 2020-10-13 |
| 1548876063 | Midwest Orthopaedics At Rush, LLC | Clinic/Center | 1000 Commerce Court, Suite 101, Bensenville, IL 60106 | 2020-09-21 |
| 1518573963 | Better Play Performance & Rehab Pllc | Clinic/Center | 1201 Waters Edge Rd, Champaign, IL 61822-8101 | 2020-09-21 |
| 1548876329 | Midwest Orthopaedics At Rush, LLC | Clinic/Center | 17130 Prime Blvd Ste 101, Lockport, IL 60441-1311 | 2020-09-17 |
| 1124631676 | Leena Bird Physical Therapy Pllc | Clinic/Center | 400 Prairie Knoll Dr, Naperville, IL 60565-4154 | 2020-08-25 |
| 1831702232 | Pararmount Physical Therapy LLC | Clinic/Center | 2960 Artesian Rd Ste 152, Naperville, IL 60564-4876 | 2020-08-25 |
| 1487263851 | Priority You Physical Therapy and Wellness Pllc | Clinic/Center | 2101 Alpine Way, Plainfield, IL 60586-5079 | 2020-07-30 |
| 1093324345 | Motogenix Concierge Physical Therapy | Clinic/Center | 111 S Morgan St Apt 620, Chicago, IL 60607-2732 | 2020-07-23 |
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| 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.