Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

The Board of Trustees of the University of Illinois

Organization Professional Counselor · NPI 1174554331

The Board of Trustees of the University of Illinois provides Professional Counselor services in Chicago, Illinois. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
10
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Practice location Address checks out

1640 W Roosevelt Rd
Chicago, IL 60608-1336
Phone: (312) 996-6695
Fax: (312) 413-0086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Early Intervention Provider Agency (primary) Taxonomy 252Y00000X
Professional Counselor Taxonomy 101YP2500X
Behavior Analyst Taxonomy 103K00000X
Clinical Psychologist Taxonomy 103TC0700X
Clinical Social Worker Taxonomy 1041C0700X
Developmental Therapist Taxonomy 222Q00000X
Physical Therapist Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X
Speech-Language Pathologist Taxonomy 235Z00000X
Occupational Medicine Clinic/Center Taxonomy 261QX0100X

Record details

NPI number1174554331
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationThe Board of Trustees of the University of Illinois
Authorized official Mary Keehn — Assoc Dean For Clinical Affairs · (312) 413-2873
Other names College Of Applied Health Sciences Faculty Practice
NPI enumeratedJuly 6, 2006
Last updated in NPPESJune 17, 2026
Certification dateJune 17, 2026
Mailing address808 S Wood St Ste 169, Chicago, IL 60612-7306

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