Organization
ILLINOIS STATE UNIVERSITY
Active
Parent organization
ILLINOIS STATE UNIVERSITY
Other names
ISU Student Health Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
ILLINOIS STATE UNIVERSITY
Authorized official
MR. JAMES KELLOGG JR. (ASSOCIATE DIRECTOR)
(309) 438-8258
Entity
Organization
Contact information
Practice address
COLLEGE AND UNIVERSITY, SUITE 2540, NORMAL, IL 61790-2540
(309) 438-8258
(309) 438-3689
Mailing address
COLLEGE AND UNIVERSITY, SUITE 2540, NORMAL, IL 61790-2540
(309) 438-8258
(309) 438-3689
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/29/2006
Last updated
06/26/2008
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