Organization
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Active
Other names
Mile Square Health Center DPP
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY STECKER (CFO)
(312) 355-7653
Entity
Organization
Contact information
Practice address
1220 S WOOD ST, CHICAGO, IL 60608-1202
(312) 413-3282
Mailing address
7702 SOLUTION CENTER, CHICAGO, IL 60677-7007
(312) 413-3282
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174H00000X
—
IL
Enumeration date
03/25/2022
Last updated
06/27/2025
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