Organization · Type 2 NPI

The Board of Trustees of University of Illinois

Nurse Practitioner · Chicago, IL

NPI number 1144093006 Active

Practice location

751 S Sacramento Blvd
Chicago, IL 60612-3365

Call (312) 413-8850 Map

Mailing address

845 S Damen Ave
Chicago, IL 60612-3727

Specialties and licenses

Taxonomy	Code	License
Pediatrics Physician	208000000X	None listed
Nurse Practitioner Primary	363L00000X	None listed
Pediatric Nurse Practitioner	363LP0200X	None listed
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	None listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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NPI record

NPI: 1144093006
Entity type: Organization (Type 2)
Issued: Nov 2, 2023
Last updated: Nov 2, 2023
Status: Active
Subpart: Yes of The Board of Trustee for the University of Illinois

Other names

Ui Health Wellness Clinic at Altus Academy · doing business as

Authorized official

Carolyn Dickens
Interim Associate Dean
(312) 413-8850

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1144093006

The Board of Trustees of University of Illinois's National Provider Identifier is 1144093006, issued on Nov 2, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Chicago, IL. The record was last updated on Nov 2, 2023.