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BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
NPI 1366129843
Clinic/Center in Springfield, IL

Active since June 28, 2023
401 N WALNUT ST, SPRINGFIELD, IL 62702(217) 545-7815 Get Directions Write a Review

NPPES record last updated: June 28, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Board Of Trustees Of Southern Illinois University NPPES

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

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY (NPI 1366129843), doing business as Survivor Recovery Center, is a healthcare organization registered as a clinic/center in Springfield, Illinois and active in the NPI registry since June 2023. The organization lists Iris Wesley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366129843
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameBOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Location Address401 N WALNUT STSpringfield, IL 62702-5033
Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000 · Fax (217) 545-2101
Phone(217) 545-7815
Organization SubpartYes
Authorized OfficialIris WesleyCeo · (217) 757-8137
Enumeration DateJune 28, 2023
NPPES CertifiedJune 28, 2023
✔ NPI 1366129843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
401 N WALNUT ST, Springfield, IL 62702
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Other Names 1

Doing Business AsSurvivor Recovery Center

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUSTIN ALLEN DAVIS
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-7027
NICOL MOORE
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 801-7295
KATHERINE L GALLOWAY MSW, LSW
Social Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-7815
KAYE BARNES
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 801-7351
MOLLY WILLIAMS
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-7027
MRS. NICOLE LYNN WATTS
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 588-8659
MOLLI CARLYLE
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 820-5720
AALIYAH SIMONE LEWIS
Community Health Worker
401 N WALNUT ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Board Of Trustees Of Southern Illinois University's NPI number?

The NPI number for Board Of Trustees Of Southern Illinois University is 1366129843. It was assigned to this organization in the NPPES registry on June 28, 2023. The provider is doing business as Survivor Recovery Center.

Where is Board Of Trustees Of Southern Illinois University located?

Board Of Trustees Of Southern Illinois University is located at 401 N Walnut St, Springfield, IL 62702. The listed phone number is (217) 545-7815.

What is Board Of Trustees Of Southern Illinois University's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Board Of Trustees Of Southern Illinois University was last updated on June 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.