NPIMap

Organization Active NPI

Usc Telehealth

  • School Social Worker
  • O Fallon, IL
National Provider Identifier
1831510833
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Legal business name
USC TELEHEALTH
Practice address
809 Deer Creek Rd
O Fallon, IL 62269-4207
Phone
(618) 726-7364
NPI assigned
Dec 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Authorized official

Name
Dr. Nadia Islam
Title
Clinical Director
Phone
(866) 740-6502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X Primary

Addresses

Primary practice location

809 Deer Creek Rd
O Fallon, IL 62269-4207

Mailing address

809 Deer Creek Rd
O Fallon, IL 62269-4207
Phone (618) 726-7364

National Provider Directory

National Provider Directory
Tax ID family
Oral Pathology Lab Usc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1831510833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 DEER CREEK RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694207",
            "telephone_number": "618-726-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 DEER CREEK RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694207",
            "telephone_number": "618-726-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USC TELEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "866-740-6502",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.