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UNIVERSITY OF ILLINOIS - CHICAGO NPI 1174554331


NPI Information

NPI: 1174554331
Provider Name: UNIVERSITY OF ILLINOIS - CHICAGO

Doing Business As: COLLEGE OF APPLIED HEALTH SCIENCES FACULTY PRACTICE

Classification: Early Intervention Provider Agency - 252Y00000X
Entity Type: Organization

CLIA Number: 14D2207304

Address:
1640 W ROOSEVELT RD
ROOM 336 (MC 628)
CHICAGO, IL
ZIP 60608
Phone: (312) 413-1567
Get Directions

UNIVERSITY OF ILLINOIS - CHICAGO is an early intervention provider agency in Chicago, IL. The provider is early intervention services are an effective way to address the needs of infants and toddlers who have developmental delays or disabilities. The services are made available through a federal law known as the Individuals with Disabilities Education Act (IDEA). IDEA provides states and territories with specific requirements for providing early intervention services to infants and toddlers with special needs. In turn, each state and territory develops its own policies for carrying out IDEA and its requirements. Broadly speaking, early intervention services are special services for eligible infants and toddlers and their families. These services are designed to identify and meet children's needs in five developmental areas. These areas are: physical development, cognitive development, communication, social or emotional development, and adaptive development. UNIVERSITY OF ILLINOIS - CHICAGO NPI is 1174554331. The provider is registered as an organization entity type.
The provider Is Doing Business As College Of Applied Health Sciences Faculty Practice.

The provider's business location address is:

1640 W ROOSEVELT RD
ROOM 336 (MC 628)
CHICAGO, IL
ZIP 60608-316
Phone: (312) 413-1567
Fax: (312) 413-1993

The provider's authorized official is Bo L. Fernhall .
The authorized official title is Director and has the following contact phone number (312) 413-1567.

The CLIA number assigned to this NPI record is 14D2207304 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 1/20/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QX0100XClinic/CenterOccupational MedicineNo
2101YP2500XCounselorProfessionalNo
3103K00000XBehavior AnalystNo
4103TC0700XPsychologistClinicalNo
51041C0700XSocial WorkerClinicalNo
6222Q00000XDevelopmental TherapistNo
7225100000XPhysical TherapistNo
8225XP0200XOccupational TherapistPediatricsNo
9235Z00000XSpeech-Language PathologistNo
10252Y00000XEarly Intervention Provider AgencyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.