NPI: 1356000236
Provider Name: BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Doing Business As: IU HEALTH MILE SQUARE HEALTH CENTER PRIMARY AND IMMEDIATE CARE CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization
Specialization: Federally Qualified Health Center (FQHC)
Address:
839 W 79TH ST
CHICAGO, IL
ZIP 60620
Phone: (312) 996-2000
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BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS is a federally qualified health center (fqhc) clinic center in Chicago, IL. BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI is 1356000236. The provider is registered as an organization entity type.
The provider Is Doing Business As Iu Health Mile Square Health Center Primary And Immediate Care Center.
The provider's business location address is:
839 W 79TH ST
CHICAGO, IL
ZIP 60620-501
Phone: (312) 996-2000
The provider's authorized official is Henry Taylor .
The authorized official title is Ceo and has the following contact phone number (312) 413-1261.
The enumeration date for this NPI number is 12/8/2021 and was last updated on 2/9/2022.