# NORTHERN ILLINOIS UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TriCounty Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225218365
- **Authorized official:** MRS. MARY PRITCHARD PH.D. (INTERIM DEAN)
- **Authorized official phone:** (815) 753-6155

## Contact information

- **Practice address:** 21193 MALTA RD, MALTA, IL 60150-9600
- **Practice address phone:** (815) 753-9010
- **Practice address fax:** (815) 753-9018
- **Mailing address:** 21193 MALTA RD, MALTA, IL 60150-9600
- **Mailing address phone:** (815) 753-9010
- **Mailing address fax:** (815) 753-9018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 04/27/2012