Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Parent organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF
Other names
UIH-Mile Square Health Center at South Shore
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF
Authorized official
MR. TIMOTHY STECKER (CFO)
(312) 355-7653
Entity
Organization
Contact information
Practice address
7037 S. STONY ISLAND, UIH-MILE SQUARE HEALTH CENTER AT SOUTH SHORE, CHICAGO, IL 60649
(773) 256-0526
(312) 413-7812
Mailing address
1220 S. WOOD STREET, UIH-MILE SQUARE HEALTH CENTER, CHICAGO, IL 60608-1202
(312) 413-1261
(312) 413-7815
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS PROVIDER
1622185
IL
Enumeration date
07/17/2006
Last updated
07/10/2025
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