Organization
UIC COLLEGE OF DENTISTRY ORAL PATHOLOGY BIOPSY SERVICE
Active
Parent organization
UNIVERSITY OF ILLINOIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF ILLINOIS
Authorized official
SARA C GORDON DDS MSC FRCDC (DIRECTOR)
(312) 996-1104
Entity
Organization
Contact information
Practice address
801 S PAULINA ST, ROOM 525A (M/C 838), CHICAGO, IL 60612-7210
(312) 996-3633
(312) 996-9226
Mailing address
801 S PAULINA ST, ROOM 525A (M/C 838), CHICAGO, IL 60612-7210
(312) 996-3633
(312) 996-9226
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0646690
IL
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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