Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Other names
Dept of Urology
Organization subpart
No
Provider details
NPI number
Authorized official
KAILAS SANGHANI (DIRECTOR OF FINANCE)
(312) 413-1350
Entity
Organization
Contact information
Practice address
820 S WOOD ST, CHICAGO, IL 60612-4325
(312) 996-2779
Mailing address
7732 SOLUTION CENTER, CHICAGO, IL 60677-0001
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619048
BCBS GROUP
IL
01
—
CG6661
RAILROAD GROUP
IL
Enumeration date
04/25/2007
Last updated
05/18/2022
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