institution
The Board Of Trustees Of The University Of Illinois
Adolescent and Children Mental Health Clinic/Center in Chicago, Illinois
NPI 1609822147

The Board Of Trustees Of The University Of Illinois is an Adolescent and Children Mental Health Clinic/Center based in Chicago, IL and is specialized in Adolescent and Children Mental Health. 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 1609822147 and holds a License No. (Illinois).

The current practice location address for The Board Of Trustees Of The University Of Illinois is 912 S Wood St, Chicago, IL and can be reached out via phone at 312-413-3783 and via fax at 312-996-3514.

Location: 912 S Wood St, Chicago, IL, 60677-7008
institution
Provider Profile Details
NPI Number
1609822147
Provider Name
The Board Of Trustees Of The University Of Illinois
Credential
Provider Entity Type
Organization
Address
912 S Wood St, Chicago, IL, 60677-7008
Phone Number
312-413-3783
Fax Number
312-996-3514
Provider Enumeration Date
05/26/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
203465 01 IL MEDICARE APN/CNS
01618662 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
912 S Wood St
City
State
Zip
60612-4300
Phone Number
312-413-3783
Fax Number
312-996-3514
person
Provider Business Mailing Address Details
Address
912 S Wood St
City
State
Zip
60612-4300
Phone Number
312-413-3783
Fax Number
312-996-3514
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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