# UNIVERSITY OF ILLINOIS AT CHICAGO

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

## Provider details

- **NPI number:** 1437407897
- **Authorized official:** JAY TRAN PHARMD (CLINICAL PHARMACIST)
- **Authorized official phone:** (312) 355-4081

## Contact information

- **Practice address:** 833 S WOOD ST, CHICAGO, IL 60612-7229
- **Practice address phone:** (312) 355-4081
- **Mailing address:** 833 S WOOD ST, CHICAGO, IL 60612-7229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 051291932 | IL | Yes |

## Other

- **Enumeration date:** 08/16/2012
- **Last updated:** 08/16/2012