institution
The Board Of Trustees Of The University Of Illinois
Federally Qualified Health Center (FQHC) in Chicago, Illinois
NPI 1205022506

The Board Of Trustees Of The University Of Illinois is a Federally Qualified Health Center (FQHC) based in Chicago, IL and is specialized in Federally Qualified Health Center (FQHC). The Board Of Trustees Of The University Of Illinois practices in Chicago, IL. The NPI Number for The Board Of Trustees Of The University Of Illinois is 1205022506 and holds a License No. (Illinois).

The current practice location address for The Board Of Trustees Of The University Of Illinois is 1110 W Belmont Ave, Chicago, IL and can be reached out via phone at 312-996-9354 and via fax at 312-996-7725.

Location: 1110 W Belmont Ave, Chicago, IL, 60657-3313
institution
Provider Profile Details
NPI Number
1205022506
Provider Name
The Board Of Trustees Of The University Of Illinois
Credential
Provider Entity Type
Organization
Address
1110 W Belmont Ave, Chicago, IL, 60657-3313
Phone Number
312-996-9354
Fax Number
312-996-7725
Provider Enumeration Date
09/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14-1073 01 IL MEDICARE CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
1110 W Belmont Ave
City
State
Zip
60657-3313
Phone Number
312-996-9354
Fax Number
312-996-7725
person
Provider Business Mailing Address Details
Address
1110 W Belmont Ave
City
State
Zip
60657-3313
Phone Number
312-996-9354
Fax Number
312-996-7725
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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