Board Of Trustees Of Southern Illinois University

NPI: 1104230168

Board Of Trustees Of Southern Illinois University

Q: What is Board Of Trustees Of Southern Illinois University's provider type?

Board Of Trustees Of Southern Illinois University is an Organization under CMS NPI Type 2.

ActiveOrganizationNurse Practitioner

NPI issued: June 18, 2014

Quick Facts

NPI Number

1104230168

TypeOrganization

StatusActive

SpecialtyNurse Practitioner

Taxonomy363L00000X — Nurse Practitioner

Phone

(618) 482-6959

StateIL

NPI Validation Status: Verified

✅Valid 10-digit NPI number (1104230168)

✅Active status confirmed

✅Verified by CMS NPPES Registry

✅HIPAA compliant identifier

✅Enumeration date on file (June 18, 2014)

Data source: CMS NPPES

Provider Overview

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY is a Nurse Practitioner provider based in East Saint Louis, IL who has been registered with CMS since 2014. They are affiliated with Southern Illinois University Edwardsville. This NPI is currently Active under CMS NPPES registry.

Provider Details

NPI Number1104230168

Provider TypeOrganization

StatusActive

Enumeration DateJune 18, 2014

Practice Location

CityEast Saint Louis

StateIL

ZIP Code62201-1129

Phone(618) 482-6959

Specialties & Licenses

★ Primary

SpecialtyNurse Practitioner

Taxonomy Code363L00000X

License StateIL

Mailing Address

CityEast Saint Louis

StateIL

ZIP Code62201-1129

Phone(618) 482-6959

Same as practice location

Hospital & Organization Affiliations

🏢

Southern Illinois University Edwardsville

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How to Use This NPI

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For Insurance Billing

Use NPI 1104230168 in Box 33 of the CMS-1500 claim form. This number is required by all major insurance carriers to identify the billing provider and process electronic medical claims.

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For Credentialing

Reference NPI 1104230168for provider credential verification. Hospital systems, state licensing boards, and CAQH directories query this number to verify the provider's active clinical status.

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For Patients

Share NPI 1104230168 with your insurance company. If you need to verify out-of-network benefits or file a reimbursement claim, your insurance provider will require this number to process it.

About Nurse Practitioner

Family Nurse Practitioners (FNPs) provide comprehensive primary healthcare services across the lifespan, including diagnostic assessments, prescribing medications, and disease prevention education.

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