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SOUTHERN ILLINOIS NEUROPSYCHOLOGY LLC NPI 1861909509


NPI Information

NPI: 1861909509
Provider Name: SOUTHERN ILLINOIS NEUROPSYCHOLOGY LLC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
60 S STATE ROUTE 157
EDWARDSVILLE, IL
ZIP 62025
Phone: (618) 391-4021
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SOUTHERN ILLINOIS NEUROPSYCHOLOGY LLC is a clinical neuropsychologist in Edwardsville, IL. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. SOUTHERN ILLINOIS NEUROPSYCHOLOGY LLC NPI is 1861909509. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

60 S STATE ROUTE 157
EDWARDSVILLE, IL
ZIP 62025
Phone: (618) 391-4021

The provider's authorized official is Phillip Ruppert .
The authorized official title is Owner and has the following contact phone number (618) 391-4021.

The enumeration date for this NPI number is 1/3/2018 and was last updated on 2/10/2022.


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
1103G00000XClinical Neuropsychologist071009269ILLINOISYes

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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