Organization · Type 2 NPI

Board of Trustees of the University of Illinois

Federally Qualified Health Center (FQHC) · Chicago, IL

NPI number 1790704484 Active

Practice location

1059 W 13th St
Chicago, IL 60608-1526

Call (312) 996-2000 Map

Fax (312) 413-1782

Mailing address

2045 W Washington Blvd, M/c 698
Chicago, IL 60612-2428

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1790704484

Board of Trustees of the University of Illinois's National Provider Identifier is 1790704484, issued on Jul 19, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Chicago, IL. The record was last updated on Feb 21, 2008.