# UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033467857
- **Authorized official:** DR. HOLLY A ROSENCRANZ M.D, MA, FACP (PROGRAM DIRECTOR)
- **Authorized official phone:** (217) 383-3110

## Contact information

- **Practice address:** 611 W PARK ST, CARLE FORUM, LL, URBANA, IL 61801-2500
- **Practice address phone:** (217) 383-3110
- **Practice address fax:** (217) 244-0621
- **Mailing address:** 611 W PARK ST, CARLE FORUM, LL, URBANA, IL 61801-2500
- **Mailing address phone:** (217) 383-3110
- **Mailing address fax:** (217) 244-0621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 125060935 | IL | Yes |

## Other

- **Enumeration date:** 08/28/2012
- **Last updated:** 08/28/2012