THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI 1205022506

NPI Information

THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS is a federally qualified health center (fqhc) clinic center in Chicago, IL. THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI is 1205022506. The provider is registered as an organization entity type.
The provider Is Doing Business As Mile Square- Ihc Thresholds Mothers Program.

The provider's business location address is:

1110 W BELMONT AVE
IHC THRESHOLDS MOTHERS PROGRAM
CHICAGO, IL
ZIP 60657-313
Phone: (312) 996-9354
Fax: (312) 996-7725

The provider's authorized official is William R Nicolas .
The authorized official title is Executive Director Uic Medical Pla and has the following contact phone number (312) 413-0573.

The enumeration date for this NPI number is 9/20/2007 and was last updated on 8/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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