Organization · Type 2 NPI

The Board of Trustees of the University of Illinois

Federally Qualified Health Center (FQHC) · Chicago, IL

NPI number 1932450160 Active

Practice location

3050 W 39th Pl
Chicago, IL 60632-2402

Call (312) 413-1261 Map

Fax (312) 413-7812

Mailing address

2045 W Washington Blvd
Chicago, IL 60612-2428

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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

Another provider at this address

Arin Stone, PSY.D.Psychologist Chicago, IL NPI 1194851121

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NPI record

NPI: 1932450160
Entity type: Organization (Type 2)
Issued: Sep 27, 2012
Last updated: Oct 15, 2020
Status: Active

Other names

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Uic,mile Square Health Center,davis Health and Wellness Center · doing business as
Uic,mile Square Health Center,davis Health and Wellness Center · doing business as

Authorized official

Mr. Henry Taylor, CEO
Executive Director
(312) 312-1261

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About NPI 1932450160

The Board of Trustees of the University of Illinois's National Provider Identifier is 1932450160, issued on Sep 27, 2012. 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 Oct 15, 2020.