Department Of Psychiatry

LBN: Board Of Trustees Of Southern Illinois University
Department Of Psychiatry is an health care organization with primary practice located at 901 W Jefferson St , Springfield IL 62702-4833. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Board Of Trustees Of Southern Illinois University can be contacted via phone (217) 545-8229, or through Tkach, David J via phone (217) 545-7578.

Contact Information

Primary practice address
901 W Jefferson St Springfield IL 62702-4833
Phone: (217) 545-8229
Fax: (217) 545-2275
Website:
Map and Directions
Authorized official contact:
Name: Tkach, David J
Phone: (217) 545-7578

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 10-0066401 Illinois

Profile Details

NPI number 1558539882
LBN Legal business name Board Of Trustees Of Southern Illinois University
DBA Doing business as Department Of Psychiatry
Authorized official Tkach, David J
Entity Organization
Organization subpart 1 No
Enumeration date Feb 20th, 2008
Last updated Jun 19th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558539882 NPPES
Illinois MEDICAID 100066401002

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