THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS NPI 1932450160

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 1932450160. The provider is registered as an organization entity type.
The provider Is Doing Business As Uic,mile Square Health Center,davis Health And Wellness Center.

The provider's business location address is:

3050 W 39TH PL
CHICAGO, IL
ZIP 60632-402
Phone: (312) 413-1261
Fax: (312) 413-7812

The provider's authorized official is Henry Taylor .
The authorized official title is Executive Director and has the following contact phone number (312) 312-1261.

The enumeration date for this NPI number is 9/27/2012 and was last updated on 10/15/2020.

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

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

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