UNIVERSITY OF ILLINOIS (NPI# 1871725028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871725028 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF ILLINOIS |
| Other Organization Name | UIC SOUTH LOOP PHYSICIANS GROUP |
| Practice Address |
840 S Wood St Department of Medicine, M/c 787 Chicago IL 60612-4325 |
| Mailing Address |
2600 S Michigan Ave Suite 205 Chicago IL 60616-2857 |
| Practice Telephone | 3129961823 |
| Mailing Telephone | 3129961823 |
| Mailing Fax Number | 3124135604 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |
| Authorized Official Name | TERRY THOMPSON (DIRECTOR UNIVERSITY TAX) |
| Authorized Official Telephone | 8002609113 |
| Is Organization Subpart | Y |
| Parent Organization Name | BOARD OF TRUSTEE'S |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UIC South Loop Physicians Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659431351 | University of Illinois | Public Health or Welfare | 2815 W Washington, Suite 300, Springfield, IL 62794-9481 | 2006-12-11 |
| 1861409450 | University of Illinois | Audiologist | 2001 S Oak St Ste B, Champaign, IL 61820-0912 | 2006-08-03 |
| 1962475996 | University of Illinois | Obstetrics & Gynecology | Dept. of Ob / Gyn, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-09 |
| 1174596225 | University of Illinois | Pediatrics | 515 Ne Glen Oak Ave, Pediatric Neurology, Peoria, IL 61603-3165 | 2006-02-09 |
| 1245203280 | University of Illinois | Psychiatry & Neurology | Department of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-09 |
| 1568433050 | University of Illinois | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-01 |
| 1619948411 | University of Illinois | Pediatrics | Regional Development Center, 507 E Armstrong, Peoria, IL 61603 | 2006-01-30 |
| 1275817249 | University of Illinois | General Acute Care Hospital | 611 W Park St, Carle Forum, Urbana, IL 61801-2500 | 2011-10-07 |
| 1962631010 | University of Illinois | Psychologist | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2009-07-10 |
| 1205002185 | University of Illinois | General Acute Care Hospital | 611 W Park St, Carle Forum Lower Level, Urbana, IL 61801-2500 | 2008-05-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF ILLINOIS | 809 S Marshfield 9th Flr, Chicago, IL 60612-4305 |
| Oklahoma Business Registrations | UNIVERSITY OF ILLINOIS FOUNDATION | 1305 West Green St, Urbana, IL 61801 |
| System for Award Management (SAM) Entities | UNIVERSITY OF ILLINOIS RESEARCH PARK, LLC | 60 Hazelwood Dr, Champaign, IL 61820-7460 |
| Street Address |
840 S WOOD ST DEPARTMENT OF MEDICINE, M/C 787 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-4325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354656 | Frederick G. Behm | Pathology | 840 S Wood St, Department of Pathology, Mc847, Chicago, IL 60612-4325 | 2005-05-23 |
| 1467065581 | Monica Joan Gingell | Nurse Practitioner | 840 S Wood St, Chicago, IL 60612-4325 | 2020-08-28 |
| 1003435926 | Kyle Corso Mork | Pharmacist | 840 S Wood St, Chicago, IL 60612-4325 | 2020-04-10 |
| 1841828282 | Hovig Chelebian | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2020-03-31 |
| 1417585787 | Mehul Gilani | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2020-03-31 |
| 1730736356 | Alice Zalan | Genetic Counselor, MS | 840 S Wood St, Chicago, IL 60612-4325 | 2019-08-19 |
| 1972155547 | Lenika De Simone | Genetic Counselor, MS | 840 S Wood St, Chicago, IL 60612-4325 | 2019-07-12 |
| 1528629961 | Melissa Duckett | Nurse Practitioner | 840 S Wood St, Chicago, IL 60612-4325 | 2019-06-26 |
| 1629631098 | Jonathan Alverio | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2019-04-20 |
| 1225598766 | Daphne Porat | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2019-03-21 |
| Find all providers in the same location | ||||
| 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 Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1871119172 | Irina Komissarova | Internal Medicine | 916 S Oakley Blvd, Chicago, IL 60612-4230 | 2020-06-22 |
| 1336760719 | Arslan Zahid | Internal Medicine | 5847 S Maryland Ave, Chicago, IL 60637-1463 | 2020-04-27 |
| 1104447572 | Nirmal Desai | Internal Medicine | 5841 S Maryland Ave., M/c 7082, Chicago, IL 60637-1443 | 2020-04-27 |
| 1467072447 | Justin Edmond Sipiora | Internal Medicine | 5841 S. Maryland Ave Mc 7082, Chicago, IL 60637-1443 | 2020-04-20 |
| 1003449612 | Eoht LLC | Internal Medicine | 1718 W North Shore Ave Apt 11, Chicago, IL 60626-4030 | 2020-02-21 |
| Find all providers in CHICAGO | ||||
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| 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.