Provider Type Icon

THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI 1841614609


NPI Information

NPI: 1841614609
Provider Name: THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Doing Business As: INTEGRATED HEALTH CARE - AVIVA

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3240 W DIVISION ST
CHICAGO, IL
ZIP 60651
Phone: (312) 413-7425
Get Directions

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 1841614609. The provider is registered as an organization entity type.
The provider Is Doing Business As Integrated Health Care - Aviva.

The provider's business location address is:

3240 W DIVISION ST
CHICAGO, IL
ZIP 60651-405
Phone: (312) 413-7425
Fax: (312) 996-3512

The provider's authorized official is Elizabeth M Raleigh .
The authorized official title is Director and has the following contact phone number (312) 996-7663.

The enumeration date for this NPI number is 2/13/2014 and was last updated on 1/22/2016.


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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1781821MEDICARE OSCAR/CERTIFICATIONILLINOIS
21622185OTHERILLINOISBCBS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.