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BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI 1336187749


NPI Information

NPI: 1336187749
Provider Name: BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Doing Business As: UNIVERSITY PRIMARY CARE CLINIC AT BELVIDERE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2046324

Address:
2170 PEARL ST
BELVIDERE, IL
ZIP 61008
Phone: (815) 547-5461
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BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS is a family medicine in Belvidere, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI is 1336187749. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As University Primary Care Clinic At Belvidere.

The provider's business location address is:

2170 PEARL ST
BELVIDERE, IL
ZIP 61008-020
Phone: (815) 547-5461
Fax: (815) 544-9681

The provider's authorized official is John Fitzhorn .
The authorized official title is Director Of Patient Accounts and has the following contact phone number (815) 395-5892.

The CLIA number assigned to this NPI record is 14D2046324 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 9/10/2007.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1617260MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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