BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI 1790826352

NPI Information

NPI: 1790826352
Provider Name: BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Doing Business As: UNIVERSITY OF ILLINOIS MILE SQUARE NEIGHBORHOOD CLINIC PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
1220 S WOOD ST
ROOM 1045 MC 884
CHICAGO, IL
ZIP 60608
Phone: (312) 413-1767
Get Directions

BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS is a clinic pharmacy pharmacy in Chicago, IL. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI is 1790826352. The provider is registered as an organization entity type.
The provider Is Doing Business As University Of Illinois Mile Square Neighborhood Clinic Pharmacy.

The provider's business location address is:

1220 S WOOD ST
ROOM 1045 MC 884
CHICAGO, IL
ZIP 60608-202
Phone: (312) 413-1767
Fax: (312) 355-1916

The provider's authorized official is Kristine D Vankuiken .
The authorized official title is Pharmacy Technician Specialist and has the following contact phone number (312) 355-2035.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 4/21/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3336C0002X	Pharmacy	Clinic Pharmacy	054.017118	ILLINOIS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	054-017118	OTHER	ILLINOIS	STATE PHARMACY LICENSE
2	093-010041	OTHER	ILLINOIS	STATE LICENSE NUMBER
3	BM2594011	OTHER	ILLINOIS	DEA NUMBER
4	032-005960	OTHER	ILLINOIS	STATE CONTROLLED SUBSTANC
5	1418006	OTHER	IDAHO	NCPDP 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

NPI Synchronization or Removal

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