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Organization
BOARD OF TRUSTEES FO THE UNIVERSITY OF ILLINOIS
Active
Organization
BOARD OF TRUSTEES FO THE UNIVERSITY OF ILLINOIS
Active
Other names
UIC Craniofacial Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC WILLIAM DEVAR (CHIEF OPERATING OFFICER)
(312) 376-1607
Entity
Organization
Contact information
Practice address
811 S PAULINA ST # MC588, CHICAGO, IL 60612-4353
(312) 996-7546
Mailing address
7732 SOLUTION CENTER, CHICAGO, IL 60677-0001
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/08/2013
Last updated
01/20/2022
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