Organization
UNIVERSITY OF ILLINOIS AT CHICAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE OUELLET PH.D. (EXECUTIVE DIRECTOR, COIP)
(312) 355-0145
Entity
Organization
Contact information
Practice address
1603 W TAYLOR ST, M/C 923, CHICAGO, IL 60612-4310
(312) 413-3210
(312) 996-1450
Mailing address
1603 W. TAYLOR ST., M/C 923, CHICAGO, IL 60612-4310
(312) 996-1450
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/28/2008
Last updated
02/28/2008
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