| Board Of Trustees Of Southern Illinois University | |
|
901 W Jefferson St Springfield IL 62702-4833 | |
| (217) 545-8229 | |
| (217) 545-2275 |
| Full Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 901 W Jefferson St, Springfield, Illinois |
| Authorized Official Name and Position | David J Tkach (CEO) |
| Authorized Official Contact | 2175457578 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of Southern Illinois University Po Box 19642 Springfield IL 62794-9642 Ph: (217) 545-8229 | Board Of Trustees Of Southern Illinois University 901 W Jefferson St Springfield IL 62702-4833 Ph: (217) 545-8229 |
| NPI Number | 1558539882 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558539882 | NPI | - | NPPES |
| 100066401002 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10-0066401 (Illinois) | Primary |
Gray Therapy Group, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Chatham Rd Ste N, Springfield, IL 62704 Phone: 847-834-9189 | |
Comprehensive Psychological & Health Association Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Chatham Road, #5714, Springfield, IL 62704 Phone: 954-686-2020 Fax: 954-604-6506 | |
Resilience Aba Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6405 Mcintosh Ct, Springfield, IL 62711 Phone: 618-967-8859 | |
Balm Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Chatham Rd Ste 5848, Springfield, IL 62704 Phone: 386-334-2161 | |
Lighthouse Counseling Solutions, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Chatham Rd Ste 8089, Springfield, IL 62704 Phone: 847-316-0325 | |
Mizani Therapeutic Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Chatham Rd # 5051, Springfield, IL 62704 Phone: 773-916-6513 | |
Behavior On Demand Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Chatham Rd Ste R, Springfield, IL 62704 Phone: 312-868-1404 |