NORTHERN ILLINOIS UNIVERSITY NPI 1780990051

NPI Information

  • NPI: 1780990051
  • Provider Name: NORTHERN ILLINOIS UNIVERSITY
  • Classification: Clinic/Center - 261QR0400X
  • Specialization: Rehabilitation
  • Entity Type: Organization
  • Doing Business As: SPORTS MEDICINE
  • Address: 1525 W LINCOLN HWY
    SUITE 170-NIU ATHLETIC TRAINING
    DEKALB, IL
    ZIP 60115
  • Phone: (815) 753-0211

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NPI Details

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 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
1261QR0400XClinic/CenterRehabilitation096000344ILLINOISYes

What is NPI?

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This page was last updated on: 3/30/2025

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