Organization
BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Other names
University Psychiatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FITZHORN (DIRECTOR OF PATIENT ACCOUNTS)
(815) 395-5892
Entity
Organization
Contact information
Practice address
1601 PARKVIEW AVE, ROCKFORD, IL 61107-1822
(815) 395-5870
Mailing address
1601 PARKVIEW AVE, S300, ROCKFORD, IL 61107-1822
(815) 395-5892
(815) 395-5644
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/03/2006
Last updated
09/10/2007
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