Organization · Type 2 NPI

Illinois State University

Health Service Clinic/Center · Normal, IL

NPI number 1336216027 Active

Practice location

College And University, Suite 2540
Normal, IL 61790-2540

Fax (309) 438-3689

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center Primary	261QH0100X	None listed

Health Service Clinic/Center: Definition to come...

NPI record

NPI: 1336216027
Entity type: Organization (Type 2)
Issued: Nov 29, 2006
Last updated: Jun 26, 2008
Status: Active
Subpart: Yes of Illinois State University

Other names

<unavail>
Isu Student Health Service · doing business as

Authorized official

Mr. James Kellogg
Associate Director
(309) 438-8258

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1336216027

Illinois State University's National Provider Identifier is 1336216027, issued on Nov 29, 2006. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Normal, IL. The record was last updated on Jun 26, 2008.