NPIMap

Organization Active NPI

Northern Illinois University

Doing business as Northern Illinois University Institute for Neutron Therapy at Fermilab

  • Radiation Oncology Clinic/Center
  • Batavia, IL
National Provider Identifier
1144327487
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X
Legal business name
NORTHERN ILLINOIS UNIVERSITY
Doing business as
Northern Illinois University Institute for Neutron Therapy at Fermilab
Practice address
Kirk and Pine Rd
Batavia, IL 60510
Phone
(630) 840-3865
NPI assigned
Sep 20, 2006
Last updated
May 13, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHERN ILLINOIS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Peters, PHD
Title
President
Phone
(815) 753-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Clinic/Center 261QX0203X Primary

Addresses

Primary practice location

Kirk and Pine Rd
Batavia, IL 60510

Mailing address

307 Lowden Hall
Niu Outreach
Dekalb, IL 60115-3080
Phone (815) 753-0924

Other names 1

  • Northern Illinois University Institute for Neutron Therapy at Fermilab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000460 IL Part B Supplier - Clinic/Group Practice 2860440195 Receives reassigned benefits from 17 practitioners
4 other NPIs on this enrollment
Practice locations: Dekalb, IL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Psychological Services

Locations

307 Lowden Hall
DeKalb, IL 60115

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1144327487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 LOWDEN HALL",
            "address_2": "NIU OUTREACH",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601153080",
            "telephone_number": "815-753-0924",
            "fax_number": "815-753-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KIRK AND PINE RD",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "60510",
            "telephone_number": "630-840-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN ILLINOIS UNIVERSITY",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-753-9500",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Illinois University Institute for Neutron Therapy at Fermilab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Batavia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.