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Organization

UNIVERSITY OF ILLINOIS

Active
Parent organization
BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Other names
Department of Speech and Hearing Science, University of Illinois Audiology Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Authorized official
CLARION MENDES CCC-SLP (DIRECTOR OF CLINICAL EDUCATION)
(217) 333-2205
Entity
Organization

Contact information

Practice address
2001 S OAK ST STE B, CHAMPAIGN, IL 61820-0912
(217) 333-2205
(217) 333-2206
Mailing address
2001 S OAK ST STE B, CHAMPAIGN, IL 61820-0912
(217) 333-2205
(217) 333-2206

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147.000339
IL

Other

Enumeration date
08/03/2006
Last updated
08/27/2019
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