institution
Board Of Trustees Of The University Of Illinois
Federally Qualified Health Center (FQHC) in Chicago, Illinois
NPI 1790704484

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). Board Of Trustees Of The University Of Illinois practices in Chicago, IL. The NPI Number for Board Of Trustees Of The University Of Illinois is 1790704484 and holds a License No. (Illinois).

The current practice location address for Board Of Trustees Of The University Of Illinois is 1059 W 13Th St, Chicago, IL and can be reached out via phone at 312-996-2000 and via fax at 312-413-1782.

Location: 1059 W 13Th St, Chicago, IL, 60612-2428
institution
Provider Profile Details
NPI Number
1790704484
Provider Name
Board Of Trustees Of The University Of Illinois
Credential
Provider Entity Type
Organization
Address
1059 W 13Th St, Chicago, IL, 60612-2428
Phone Number
312-996-2000
Fax Number
312-413-1782
Provider Enumeration Date
07/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1622185 01 BCBS PROVIDER ID
institution
Provider Business Practice Location Address Details
Address
1059 W 13Th St
City
State
Zip
60608-1526
Phone Number
312-996-2000
Fax Number
312-413-1782
person
Provider Business Mailing Address Details
Address
1059 W 13Th St
City
State
Zip
60608-1526
Phone Number
312-996-2000
Fax Number
312-413-1782
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
()
Definition
Definition to come...
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