Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Other names
Mile Square Dr. Cynthia Barnes-Boyd/Drake Health and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA MARIE LEVITSKE (DIRECTOR OF FINANCE)
(312) 996-0566
Entity
Organization
Contact information
Practice address
2710 S DEARBORN ST, CHICAGO, IL 60616-2684
(312) 355-5746
Mailing address
818 S WOLCOTT AVE STE 811, CHICAGO, IL 60612-3702
(312) 996-9787
(312) 996-3848
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/27/2019
Last updated
08/09/2019
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