ILLINOIS STATE UNIVERSITY (NPI# 1336216027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336216027 |
| Entity Type | Organization |
| Organization Name | ILLINOIS STATE UNIVERSITY |
| Other Organization Name | ISU STUDENT HEALTH SERVICE |
| Practice Address |
College and University Suite 2540 Normal IL 61790-2540 |
| Practice Telephone | 3094388258 |
| Practice Fax Number | 3094383689 |
| Mailing Telephone | 3094388258 |
| Mailing Fax Number | 3094383689 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | MR. JAMES KELLOGG JR. (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 3094388258 |
| Is Organization Subpart | Y |
| Parent Organization Name | ILLINOIS STATE UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ISU Student Health Service | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669616983 | Illinois State University | Audiologist-Hearing Aid Fitter | 275 S University St, Campus Box 4720, Normal, IL 61790-4720 | 2009-04-30 |
| 1770615502 | Illinois State University | Psychologist | 408 Fairchild Hall, Campus Box 4625, Normal, IL 61790 | 2007-03-09 |
| 1952460388 | Illinois State University | Pharmacy | 101 N University St, Normal, IL 61790-2540 | 2006-12-08 |
| Street Address |
COLLEGE AND UNIVERSITY SUITE 2540 |
| City | NORMAL |
| State | IL |
| Zip Code | 61790-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124478714 | Noelle Selkow | Specialist/Technologist | 251c Mcormick Hall, Campus Box 5120, Normal, IL 61790 | 2016-06-15 |
| 1679920375 | Yvette Renee Pigman | Nurse Practitioner | 201 North University, Illinois State Studnet Health Services, Normal, IL 61790 | 2016-05-23 |
| 1912263815 | Kelly Haley | Specialist/Technologist | 7130 Horton Fieldhouse, Normal, IL 61790 | 2012-04-04 |
| 1023391331 | Marie Rupert | Pharmacist | 201 N University Street, Normal, IL 61790 | 2011-09-22 |
| 1770615502 | Illinois State University | Psychologist | 408 Fairchild Hall, Campus Box 4625, Normal, IL 61790 | 2007-03-09 |
| 1578161865 | Abigail Hardesty | Nurse Practitioner | 201 Illinois State Univ, Normal, IL 61790-0001 | 2020-10-09 |
| 1245846989 | Susan M Carl | Nurse Practitioner | 201 North University Street, Normal, IL 61790-0001 | 2020-09-18 |
| 1891336277 | Rebecca Ludolph | Registered Nurse | 201 N University, Normal, IL 61790-0001 | 2019-10-07 |
| 1184188633 | Rachel Elizabeth Heinz | Specialist/Technologist | 347 Illinois State Univ, Normal, IL 61790-0001 | 2019-01-29 |
| 1487118063 | Jean Sawyer | Speech-Language Pathologist | Mail Code 4720, Normal, IL 61790-0001 | 2019-01-28 |
| Find all providers in zip 61790 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133985 | Activate Healthcare | Clinic/Center | 2930 Montvale Dr Ste C, Springfield, IL 62704-5376 | 2020-10-30 |
| 1841899788 | Neuro Drive Pt, Pllc | Clinic/Center | 2300 W Wabansia Ave Apt 107, Chicago, IL 60647-5355 | 2020-10-21 |
| 1952929119 | Gray Healthcare Consulting Pllc | Clinic/Center | 57 Northgate Rd, Riverside, IL 60546-1638 | 2020-07-13 |
| 1225664683 | Men's Clinic, Pllc | Clinic/Center | 2700 S River Rd Ste 309, Des Plaines, IL 60018-4101 | 2020-03-18 |
| 1396389417 | Hirsch Advanced Practice Providers Ltd | Clinic/Center | 11422 S Western Ave, Chicago, IL 60643-4120 | 2019-10-31 |
| 1497308761 | Exquisite Care Spa and Wellness Inc. | Clinic/Center | 3257 N Sheffield Ave Ste 116, Chicago, IL 60657-2276 | 2019-07-16 |
| 1437612405 | Voice of Reason Counseling, LLC | Clinic/Center | 6634 S Knox Ave, Chicago, IL 60629-5643 | 2019-04-08 |
| 1215499405 | Leading Physician Partners Aco LLC | Clinic/Center | 715 W Lake St Ste 202, Addison, IL 60101-2082 | 2019-04-05 |
| 1346708815 | Erin Conway, Psyd, PC | Clinic/Center | 444 S Rand Rd Ste 214, Lake Zurich, IL 60047-2307 | 2019-03-04 |
| 1891252078 | Essence Healthcare Services LLC | Clinic/Center | 10449 Venice Ln, Orland Park, IL 60467-8218 | 2019-02-25 |
| Find all providers with the same taxonomy | ||||
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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.