Organization
UNIVERSITY OF ILLINOIS AT CHICAGO MEDICAL CENTER
Active
Organization
UNIVERSITY OF ILLINOIS AT CHICAGO MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN THOMAS HUNTINGTON M.D. (RESIDENT PHYSICIAN)
(208) 863-7795
Entity
Organization
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
1203 E BRIGHTWATER LN, BOISE, ID 83706-6718
(208) 863-7795
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
209007222
IL
273100000X
Epilepsy Hospital Unit
209007222
IL
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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