Organization · Type 2 NPI
Board of Trustees of Southern Illinois University
Nurse Practitioner · East St. Louis, IL
Practice location
601 James R Thompson Blvd, Building D, Suite 2015
East St. Louis, IL 62201-1129
Fax (618) 482-8311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | None listed |
| Nurse Practitioner Primary | 363L00000X | None listed |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
9 other providers at this address
- Southern Illinois UniversityClinic/Center East St. Louis, IL NPI 1306273776
- Southern Illinois University EdwardsvilleHealth Service Clinic/Center East St. Louis, IL NPI 1518140326
- Chontay L. McKay, FNP-CFamily Nurse Practitioner East St. Louis, IL NPI 1649622622
- Christopher Wayne Barry, LMSW, CRADCSocial Worker East St. Louis, IL NPI 1518684299
- Janet C. Whitworth, RN, FNP-BC, DNPFamily Nurse Practitioner East St. Louis, IL NPI 1467753459
- Kim Wenona White, CNS-BCClinical Nurse Specialist East St. Louis, IL NPI 1427470368
- Megan Degroot, LCSWMental Health Counselor East St. Louis, IL NPI 1992153639
- Theresa M. Benassi-Powles, APN CNPPediatric Nurse Practitioner East St. Louis, IL NPI 1215078928
- Virginia L. Behrhorst, BC APRNAdult Health Nurse Practitioner East St. Louis, IL NPI 1205976636
About NPI 1104230168
Board of Trustees of Southern Illinois University's National Provider Identifier is 1104230168, issued on Jun 18, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in East St. Louis, IL. The record was last updated on Jul 15, 2026.