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Organization
UNIVERSITY OF ILLINOIS AT CHICAGO MEDICAL CENTER
Active
Organization
UNIVERSITY OF ILLINOIS AT CHICAGO MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. USHA RAJ M.D. (PROFESSOR/ HEAD DEPT OF PEDIATRICS)
(312) 413-1429
Entity
Organization
Contact information
Practice address
840 S WOOD ST, CHICAGO, IL 60612-4325
(312) 413-1429
Mailing address
1105 BRIGHTON DR, CAROL STREAM, IL 60188-4327
(630) 483-1789
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
209007222
IL
273100000X
Epilepsy Hospital Unit
209007222
IL
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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