# THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dept of Ophthalmology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720208135
- **Authorized official:** KAILAS SANGHANI (DIRECTOR OF FINANCE)
- **Authorized official phone:** (312) 413-1350

## Contact information

- **Practice address:** 1855 W TAYLOR ST, CHICAGO, IL 60612-7243
- **Practice address phone:** (312) 996-0933
- **Mailing address:** 7732 SOLUTION CENTER, CHICAGO, IL 60677-0001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 11/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01615121 | BCBS | IL |
| 01 | — | CA3699 | RAILROAD GROUP | IL |