Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABRIANNA CUMMINGS (LEAD CREDENTIALING SPECIALIST)
(773) 757-4364
Entity
Organization
Contact information
Practice address
1640 W ROOSEVELT RD, CHICAGO, IL 60608-1316
(312) 413-8043
(312) 413-8333
Mailing address
5254 SOLUTION CENTER UIC BEHAVIORAL HEALTH CLINIC, CHICAGO, IL 60677-0001
(312) 996-1000
(312) 996-1001
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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