NORTHERN ILLINOIS UNIVERSITY (NPI# 1780990051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780990051 |
| Entity Type | Organization |
| Organization Name | NORTHERN ILLINOIS UNIVERSITY |
| Other Organization Name | SPORTS MEDICINE |
| Practice Address |
1525 W Lincoln Hwy Suite 170-niu Athletic Training Dekalb IL 60115-3989 |
| Practice Telephone | 8157530211 |
| Practice Fax Number | 8157531402 |
| Mailing Telephone | 8157530211 |
| Mailing Fax Number | 8157531402 |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2010-08-25 |
| Authorized Official Name | PHILLIP EDWARD VOORHIS (ASSISTANT ATHLETIC DIRECTOR) |
| Authorized Official Telephone | 8157530211 |
| Authorized Official Credential | ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
096000344 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sports Medicine | 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 |
| 1205061769 | Northern Illinois University | Speech-Language Pathologist | 3100 Sycamore Road, Niu Speech Language Hearing Clinic, Dekalb, IL 60115-2899 | 2009-05-27 |
| 1194991216 | Northern Illinois University | Clinic/Center | 3100 Sycamore Rd, Dekalb, IL 60115-9621 | 2008-05-08 |
| 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 |
1525 W LINCOLN HWY SUITE 170-NIU ATHLETIC TRAINING |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-3989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598862492 | Christopher James Joseph | Specialist/Technologist | 1525 W Lincoln Hwy, Convocation Center, Dekalb, IL 60115-3989 | 2006-09-20 |
| 1578119699 | Emily Belcher | Emergency Medicine | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2019-08-14 |
| 1902384936 | Kody Anderson | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2018-08-01 |
| 1922505684 | Pablo Valencia-garcia | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2018-04-10 |
| 1538606132 | Kelsey Cannon | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2017-01-21 |
| 1316484041 | Jill Pohlman | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2017-01-19 |
| 1619414307 | William Eugene Kerr IIi | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2017-01-19 |
| 1144766825 | Nathan Reed | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2017-01-18 |
| 1043621485 | Matthew David Kuehl | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2014-05-19 |
| 1063656163 | Natalie R Meckstroth | Specialist/Technologist | 1525 W Lincoln Hwy, Dekalb, IL 60115-3989 | 2009-04-21 |
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| 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 | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
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| 1093320855 | Rci (wrs), LLC. | Clinic/Center | 17 West 580 Butterfield Road, Oakbrook Terrace, IL 60181 | 2020-09-09 |
| 1558975706 | Rci (wrs), LLC. | Clinic/Center | 370 Bank Dr, Mchenry, IL 60050-0506 | 2020-09-04 |
| 1588278741 | Rci (wrs), LLC. | Clinic/Center | 1151 S State St, Chicago, IL 60605-2304 | 2020-09-04 |
| 1487268553 | Rci (wrs), LLC. | Clinic/Center | 15 Tower Ct Ste 235, Gurnee, IL 60031-3354 | 2020-09-04 |
| 1285248351 | Rci (wrs), LLC. | Clinic/Center | 884 S Rand Rd Ste A, Lake Zurich, IL 60047-3412 | 2020-09-04 |
| 1295349355 | Rci (wrs), LLC. | Clinic/Center | 140 N Addison Ave Fl 2, Elmhurst, IL 60126-2810 | 2020-09-04 |
| 1043824287 | Rci (wrs), LLC. | Clinic/Center | 1525 E 55th St Ste 305, Chicago, IL 60615-5576 | 2020-09-04 |
| 1396359469 | Rci (wrs), LLC. | Clinic/Center | 939 W North Ave Ste 300, Chicago, IL 60642-7139 | 2020-09-04 |
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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.