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Organization
NORTHERN ILLINOIS UNIVERSITY
Active
Organization
NORTHERN ILLINOIS UNIVERSITY
Active
Other names
Northern Illinois University Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL VOORHIS LAT MSED. (ASSOCIATE ATHLETIC DIRECTOR)
(815) 753-0211
Entity
Organization
Contact information
Practice address
1525 W LINCOLN HWY, DEKALB, IL 60115-3989
(815) 753-0211
Mailing address
1525 W LINCOLN HWY STE 170, DEKALB, IL 60115-3989
(815) 753-0211
(815) 753-2415
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036.08668
IL
208000000X
Pediatrics Physician
Primary
036.08668
IL
Other
Enumeration date
09/01/2016
Last updated
04/07/2026
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