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Contact Information

ILLINOIS STATE UNIVERSITY
408 FAIRCHILD HALL
CAMPUS BOX 4625
NORMAL, IL61790
 Phone: 309-438-5629
 Fax: 309-438-7476
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ILLINOIS STATE UNIVERSITY

NPI Number 1770615502
LBN Legal business name ILLINOIS STATE UNIVERSITY
Authorized official BRENDA HUBER - (CLINICAL PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 03/09/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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