ILLINOIS STATE UNIVERSITY (NPI# 1952460388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952460388 |
| Entity Type | Organization |
| Organization Name | ILLINOIS STATE UNIVERSITY |
| Other Organization Name | IL STATE UNIVERSITY HEALTH SVC |
| Practice Address |
101 N University St Normal IL 61790-2540 |
| Mailing Address |
Campus Box 2540 Pharmacy Normal IL 61790-2540 |
| Practice Telephone | 3094388713 |
| Practice Fax Number | 3094387569 |
| Mailing Telephone | 3094388713 |
| Mailing Fax Number | 3094387569 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2017-05-01 |
| Authorized Official Name | PATRICK MORALEDA (PIC) |
| Authorized Official Telephone | 3099382427 |
| Authorized Official Credential | BS PHARM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054017028 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 1999303700 | 05 | |
| PK | 2021237 | 01 |
| Other Name | Type Code |
|---|---|
| IL STATE UNIVERSITY HEALTH SVC | 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 |
| 1336216027 | Illinois State University | Clinic/Center | College and University, Suite 2540, Normal, IL 61790-2540 | 2006-11-29 |
| Street Address |
101 N UNIVERSITY ST |
| City | NORMAL |
| State | IL |
| Zip Code | 61790-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649345786 | Brian Wayne Logue | Pharmacist | 101 N University St, Isu Health Service Pharmacy, Normal, IL 61790-2540 | 2006-11-22 |
| 1245305374 | Tamra Ann Purcell | Pharmacist | 101 N University St, Isu Health Service Pharmacy, Normal, IL 61790-2540 | 2006-11-22 |
| 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 | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962489815 | Advocate Health and Hospitals Corporation | Pharmacy | 1304 Franklin Ave, Normal, IL 61761-3558 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| 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.