# UNIVERSITY OF ILLINOIS AT CHICAGO MEDICAL CENTER

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

## Provider details

- **NPI number:** 1720513906
- **Authorized official:** DR. BRIAN THOMAS HUNTINGTON M.D. (RESIDENT PHYSICIAN)
- **Authorized official phone:** (208) 863-7795

## Contact information

- **Practice address:** 1740 W TAYLOR ST, CHICAGO, IL 60612-7232
- **Practice address phone:** (866) 600-2273
- **Mailing address:** 1203 E BRIGHTWATER LN, BOISE, ID 83706-6718
- **Mailing address phone:** (208) 863-7795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 209007222 | IL | Yes |
| 273100000X | Epilepsy Hospital Unit | 209007222 | IL | — |

## Other

- **Enumeration date:** 04/26/2017
- **Last updated:** 04/26/2017