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Contact Information

ILLINI CHRISTIAN MINISTRIES INC
204 N MAIN ST
SUITE 203
SAINT JOSEPH, IL61873
 Phone: 217-469-7566
 Fax: 217-469-2568
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ILLINI CHRISTIAN MINISTRIES INC

NPI # 1376635078
LBN Legal business name ILLINI CHRISTIAN MINISTRIES INC
Authorized official TONY KIRKMAN - (EXEC DIR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/29/2006
Last updated 12/30/2010 - About 15 years ago
Identifiers
IL License # 178003791
IL License # 180000680
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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