Board of Trustees of Southern Illinois University
Board of Trustees of Southern Illinois University is a Community/Behavioral Health Agency in Springfield, Illinois. Licensed in Illinois. Registered with an NPI since 2008.
- Licensed in
- IL
- In the registry since
- 2008
Practice location Address checks out
901 W Jefferson StSpringfield, IL 62702-4833
Phone: (217) 545-8229
Fax: (217) 545-2275
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence 10-0066401 (IL) |
|---|
Record details
| NPI number | 1558539882 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | David Tkach — Ceo · (217) 545-7578 |
| Other names | Department Of Psychiatry |
| NPI enumerated | February 20, 2008 |
| Last updated in NPPES | June 19, 2008 |
| Mailing address | Po Box 19642, Springfield, IL 62794-9642 |
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