NORTHERN ILLINOIS UNIVERSITY NPI 1780990051

NPI Information

NPI: 1780990051
Provider Name: NORTHERN ILLINOIS UNIVERSITY

Doing Business As: SPORTS MEDICINE

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

CLIA Number: 14D2196436

Address:
1525 W LINCOLN HWY
SUITE 170-NIU ATHLETIC TRAINING
DEKALB, IL
ZIP 60115
Phone: (815) 753-0211
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NORTHERN ILLINOIS UNIVERSITY is a rehabilitation clinic center in Dekalb, IL. NORTHERN ILLINOIS UNIVERSITY NPI is 1780990051. The provider is registered as an organization entity type.
The provider Is Doing Business As Sports Medicine.

The provider's business location address is:

1525 W LINCOLN HWY
SUITE 170-NIU ATHLETIC TRAINING
DEKALB, IL
ZIP 60115-989
Phone: (815) 753-0211
Fax: (815) 753-1402

The provider's authorized official is Phillip Edward Voorhis .
The authorized official title is Assistant Athletic Director and has the following contact phone number (815) 753-0211.

The CLIA number assigned to this NPI record is 14D2196436 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/25/2010 and was last updated on 8/25/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	096000344	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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