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Organization

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

Active
Other names
NOLL MEDICAL PAVILION CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JANET R ALBERS MD (DIRECTOR)
(217) 757-8100
Entity
Organization

Contact information

Practice address
5220 S 6TH STREET RD, SUITE 1200, SPRINGFIELD, IL 62703-5735
(217) 545-8000
(217) 747-1351
Mailing address
PO BOX 19670, SPRINGFIELD, IL 62794-9670
(217) 545-8000
(217) 747-1351

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Enumeration date
10/12/2012
Last updated
03/14/2013
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