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Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Other names
UIC DEPARTMENT OF PSYCHIATRY, Department of Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
SILVIA AVILA (DIRECTOR OF REVENUE CYCLE)
(312) 413-7590
Entity
Organization
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 413-3783
(312) 996-3514
Mailing address
7825 SOLUTION CENTER, CHICAGO, IL 60677-7008
(312) 996-7383
(312) 996-3514
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618662
BLUE CROSS BLUE SHIELD
IL
01
—
203465
MEDICARE APN/CNS
IL
Enumeration date
05/26/2006
Last updated
08/31/2026
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