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SELF
NPI 1285992909
Student in an Organized Health Care Education/Training Program in Petersburg, IL

Active since May 01, 2012
16554 N MEADOW LN, PETERSBURG, IL 62675(217) 891-7941 Get Directions Write a Review

NPPES record last updated: May 1, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Self NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SELF (NPI 1285992909) is a healthcare organization registered as a student in an organized health care education/training program in Petersburg, Illinois and active in the NPI registry since May 2012. The organization lists Nathan Howarth, Physical Therapy, as its authorized official.

NPPES Registry Identity

NPI1285992909
Entity TypeOrganization
Primary Taxonomy390200000X
Legal Business NameSTUDENT
Location Address16554 N MEADOW LNPetersburg, IL 62675-6786
Mailing Address16554 N Meadow LnPetersburg, IL 62675-6786
Phone(217) 891-7941
Organization SubpartNo
Authorized OfficialNathan HowarthPhysical Therapy · (217) 891-7941
Enumeration DateMay 1, 2012
✔ NPI 1285992909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

16554 N MEADOW LN, Petersburg, IL 62675
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Other Names 1

Other NameSelf

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Reviews for SELF

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Frequently Asked Questions

What is STUDENT's NPI number?

The NPI number assigned to this healthcare provider is 1285992909, enumerated as an "organization" on May 01, 2012.

Where is the provider located?

The provider is located at 16554 N MEADOW LN PETERSBURG, IL 62675 and the phone number is (217) 891-7941.

What is the provider's specialty?

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.