Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Parent organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Authorized official
VICTORIA MARIE LEVITSKE (DIRECTOR OF FINANCE)
(312) 996-0566
Entity
Organization
Contact information
Practice address
6835 S NORMAL BLVD, CHICAGO, IL 60621-2535
(312) 355-5801
(312) 355-5802
Mailing address
818 S WOLCOTT AVE STE 811, CHICAGO, IL 60612-3702
(312) 996-9787
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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