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Organization

UNIVERSITY OF ILLINOIS SCB PHARMACY

Active
Parent organization
BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Other names
University of Illinois Taylor Street EEI Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Authorized official
KRISTINE HAYES (PHARMACY TECHNICIAN SPECIALIST)
(312) 355-2035
Entity
Organization

Contact information

Practice address
1009 S WOOD ST, ROOM 1025 MC 874, CHICAGO, IL 60612
(312) 996-6540
(312) 276-4800
Mailing address
833 S WOOD ST, ROOM 161 MC 874, CHICAGO, IL 60612-4325
(312) 355-2035
(312) 276-4800

Taxonomy

Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
054.017117
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
032-005937
STATE CONTROLLED SUBSTANC
IL
01
054-017117
STATE PHARMACY LICENSE
IL
01
1464205
NCPDP NUMBER
IL
Enumeration date
02/08/2007
Last updated
04/20/2023
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