THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS


Address: 1855 W Taylor St, Chicago, IL 60612-7243
Phone: 3129960933

THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1720208135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720208135
Entity Type Organization
Organization Name THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Other Organization Name DEPT OF OPHTHALMOLOGY
Practice Address 1855 W Taylor St
Chicago
IL 60612-7243
Mailing Address 135 S Lasalle St
Dept 3460
Chicago
IL 60674-3460
Practice Telephone 3129960933
Enumeration Date 2007-04-26
Last Update Date 2013-06-17
Authorized Official Name MS. VICTORIA LEVITSKE (DIRECTOR OF FINANCE)
Authorized Official Telephone 3129960566
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207W00000X Ophthalmology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL BCBS 01615121 01
IL RAILROAD GROUP CA3699 01

Other Provider/Organization Names

Other Name Type Code
Dept of Ophthalmology Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1427600345 The Board of Trustees of The University of Illinois Clinic/Center 6835 S Normal Blvd, Chicago, IL 60621-2535 2019-07-11
1043727571 The Board of Trustees of The University of Illinois Clinic/Center 835 S. Wolcott, Suite E-144; Mc 684, Chicago, IL 60612 2018-01-05
1871905190 The Board of Trustees of The University of Illinois Clinic/Center 840 Blackhawk Blvd, South Beloit, IL 61080-2263 2014-05-21
1841614609 The Board of Trustees of The University of Illinois Clinic/Center 3240 W Division St, Chicago, IL 60651-2405 2014-02-13
1932450160 The Board of Trustees of The University of Illinois Clinic/Center 3050 W 39th Pl, Chicago, IL 60632-2402 2012-09-27
1346596327 The Board of Trustees of The University of Illinois Clinic/Center 641 W. 63rd St, Uih-mile Square Health Center At Englewood, Chicago, IL 60621-2032 2012-07-27
1407166671 The Board of Trustees of The University of Illinois Clinic/Center 4747-51 West Cermak Rd, Uih-mile Square Health Center At Cicero, Cicero, IL 60804-2508 2010-10-20
1659501500 The Board of Trustees of The University of Illinois Durable Medical Equipment & Medical Supplies 811 S Paulina St, 118 Dent, Mc 588, Chicago, IL 60612-4353 2009-07-24
1518194364 The Board of Trustees of The University of Illinois Clinic/Center 1231 S Damen Ave, Chicago, IL 60608-1145 2009-06-19
1457523219 The Board of Trustees of The University of Illinois Clinic/Center 4630 South Bishop Street, Uih-mile Square Health Center At Back of The Yards, Chicago, IL 60609-3240 2008-04-01

Office Location

Street Address 1855 W TAYLOR ST
City CHICAGO
State IL
Zip Code 60612-7243

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255329470 Ari B Rubenfeld Specialist 1855 W Taylor St, Rm 2.42, Chicago, IL 60612-7242 2005-10-11
1336768852 Luis Alejandro Acaba-berrocal Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2020-04-14
1780213025 Michael Thomas Massengill Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2020-04-08
1528697745 Tala Al-khaled Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2020-04-08
1841829009 Johnathan Jeffers Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2020-04-08
1558990846 Can Kocasarac Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2020-04-07
1184251134 Joshua Anthony Lee Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2020-03-26
1760041479 Abigail Ann Strauss Optometrist 1855 W Taylor St, Chicago, IL 60612-7242 2019-06-07
1699237420 Katherine Grace Chen Student in an Organized Health Care Education/Training Program 1855 W Taylor St, Chicago, IL 60612-7242 2019-04-01
1235694530 Benito Valdepenas IIi Pharmacist 1855 W Taylor St, Chicago, IL 60612-7242 2019-01-31
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144839739 Sandhya Shri Kannayiram Internal Medicine 1901w Harrison Street, Chicago, IL 60612 2020-07-29
1568080174 Nastaran Ordoyo Haghani Rad Student in an Organized Health Care Education/Training Program 1950 W. Polk Street, Room 6203, Chicago, IL 60612 2020-07-09
1669090403 Marianne Gagnon-konamna Student in an Organized Health Care Education/Training Program 1950 West Polk Street, Chicago, IL 60612 2020-07-08
1922625672 Tanya Montgomery Nee Brown Pediatrics 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 2020-06-29
1124643028 Ashley Swan Dentist 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 2020-06-16
1831711381 Baillie Anne Bronner Obstetrics & Gynecology 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 2020-05-07
1154942449 Keisha Davell Cole Case Manager/Care Coordinator 612 S Western Ave Unit 1, Chicago, IL 60612 2020-04-28
1275153777 Isac Lim Student in an Organized Health Care Education/Training Program 1234 S. Wells, Chicago, IL 60612 2020-04-24
1578183414 Zachary Belden Student in an Organized Health Care Education/Training Program Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 2020-04-21
1548880560 Christina Nunez Student in an Organized Health Care Education/Training Program 801 S. Paulina Street, M/c 850, Chicago, IL 60612 2020-04-20
Find all providers in zip 60612

Taxonomy Information

Taxonomy Code 207W00000X
Grouping Allopathic & Osteopathic Physicians
Classification Ophthalmology

Taxonomy Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649894189 Lakeshore Ophthalmology, LLC Ophthalmology 2525 S Michigan Ave Fl 8, Chicago, IL 60616-2315 2020-06-01
1053940460 Neil L Ross Ophthalmology 950 N Michigan Ave Apt 5403, Chicago, IL 60611-7535 2020-04-07
1770149049 Rop Consultants LLC Ophthalmology 5228 N Virginia Ave, Chicago, IL 60625-4015 2019-05-13
1962969881 Monique Munro Ophthalmology 1855 W Taylor Street. Suite 3138 Illinois Eye and Infir, Chicago, IL 60612 2019-02-27
1063987345 Chataam Optical LLC Ophthalmology 8741 S Greenwood Ave Ste 108, Chicago, IL 60619-7058 2018-10-12
1740717149 Samuel Philip Burke Ophthalmology 1855 W Taylor St Rm 3.138, Chicago, IL 60612-7242 2017-05-16
1528430873 Yana Kiesau M.d., LLC Ophthalmology 3423 N Seeley Ave, Chicago, IL 60618-6113 2015-10-27
1245619105 Anna Mackin Ophthalmology 5841 S Maryland Ave # Mc 1052, Chicago, IL 60637-1447 2015-05-26
1932587656 John Douglas Wilgucki II Ophthalmology 1855 W Taylor St Ste 2.50, Chicago, IL 60612-7242 2015-05-14
1609253145 Mary Kathleen Russell Ophthalmology 259 E Erie St Ste 1500, Chicago, IL 60611-3111 2015-05-05
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City CHICAGO
Zip Code 60612

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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