The Board Of Trustees Of The University Of Illinois
Early Intervention Provider Agency in Chicago, IL. Organization (NPI-2).
NPI number1174554331
StatusActive
Last updated in NPPESJun 17, 2026
Details
- NPI
- 1174554331
- Entity type
- Organization (NPI-2)
- Legal business name
- The Board Of Trustees Of The University Of Illinois
- Organization subpart
- Yes
- Enumeration date
- Jul 6, 2006
- Certification date
- Jun 17, 2026
- Last updated
- Jun 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – | |
| 225100000X | Physical Therapist | – | – | |
| 103K00000X | Behavior Analyst | – | – | |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 101YP2500X | Counselor, Professional | – | – | |
| 261QX0100X | Clinic/Center, Occupational Medicine | – | – | |
| 222Q00000X | Developmental Therapist | – | – | |
| 225X00000X | Occupational Therapist | – | – |
Other names
- College Of Applied Health Sciences Faculty Practice (Doing Business As)
Practice location
1640 W Roosevelt RdChicago, IL 60608-1336
Phone 312-996-6695 · Fax 312-413-0086
Mailing address
808 S Wood St Ste 169Chicago, IL 60612-7306
Phone 312-996-6695 · Fax 312-413-0086
Authorized official
Mary Therese Keehn
Assoc Dean For Clinical Affairs
3124132873
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All 136 Early Intervention Provider Agency providers in Chicago · All 81,422 providers in Chicago
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