OrganizationActive
Southern Illinois University Student
NPI 1124064035 · Institutional Pharmacy · Carbondale, IL
Southern Illinois University Student is a Institutional Pharmacy organization in Carbondale, IL (NPI 1124064035).
Provider details
- NPI number
- 1124064035
- Entity type
- Organization
- Primary specialty
- Institutional PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Susan Chaney, Pharmacy Director(618) 453-4417
- License
- 054.017089 (IL)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
374 E Grand Ave
Carbondale, IL 62901-3962
Phone: (618) 453-4417
Fax: (618) 453-4672
Approximate (ZIP-level) locationGet directions
Mailing address
374 E Grand Ave
Carbondale, IL 62901-3962
Other names (DBA / former)
- Doing business as
- Southern Illinois University Student
Registry dates
- Enumerated
- 2006-06-20
- Last updated
- 2016-04-11
Frequently asked questions
- What is Southern Illinois University Student's NPI number?
- Southern Illinois University Student's National Provider Identifier (NPI) is 1124064035, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Illinois University Student?
- Southern Illinois University Student is classified in the NPPES registry as Institutional Pharmacy (Suppliers).
- Where is Southern Illinois University Student located?
- Southern Illinois University Student's practice location on file with NPPES is 374 E Grand Ave, Carbondale, IL 62901-3962.
- What is Southern Illinois University Student's phone number?
- The practice phone number listed in the NPPES registry for Southern Illinois University Student is (618) 453-4417.
- Who is the authorized official for Southern Illinois University Student?
- The authorized official listed on Southern Illinois University Student's NPPES record is Susan Chaney, Pharmacy Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Illinois University Student's NPI active?
- Yes — Southern Illinois University Student's NPI (1124064035) is active in the NPPES registry as of the last update on 2016-04-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.