THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1932450160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932450160 |
| Entity Type | Organization |
| Organization Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Other Organization Name | UIC,MILE SQUARE HEALTH CENTER,DAVIS HEALTH AND WELLNESS CENTER |
| Practice Address |
3050 W 39th Pl Chicago IL 60632-2402 |
| Mailing Address |
2045 W Washington Blvd Chicago IL 60612-2428 |
| Practice Telephone | 3124131261 |
| Practice Fax Number | 3124137812 |
| Mailing Telephone | 3124131261 |
| Mailing Fax Number | 3124137812 |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | MR. HENRY TAYLOR (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3123121261 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 1622185 | 01 |
| Other Name | Type Code |
|---|---|
| UIC,Mile Square Health Center,Davis Health and Wellness Center | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1205022506 | The Board of Trustees of The University of Illinois | Clinic/Center | 1110 W Belmont Ave, Ihc Thresholds Mothers Program, Chicago, IL 60657-3313 | 2007-09-20 |
| Street Address |
3050 W 39TH PL |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1982121042 | Brown Archer Dental PC | Dentist | 4893 S Archer Ave, Chicago, IL 60632 | 2017-08-29 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1265765218 | 4365 Archer Mri, LLC | Clinic/Center | 4365 South Archer Avenue, Chicago, IL 60632 | 2009-09-09 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| Find all providers in zip 60632 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| 1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
| 1427523125 | Howard Brown Health Center | Clinic/Center | 3533 W North Ave Ste 1, Chicago, IL 60647-7573 | 2018-10-09 |
| 1336626936 | Heartland International Health Center | Clinic/Center | 1631 W Jonquil Ter, Chicago, IL 60626-1103 | 2018-07-26 |
| 1760975304 | Inner-city Muslim Action Network | Clinic/Center | 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 | 2018-06-08 |
| 1417473851 | Howard Brown Health Center | Clinic/Center | 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 | 2017-08-17 |
| 1487193181 | Mile Square Englewood/cook Satellite Health and Wellness Center | Clinic/Center | 8150 S Bishop St, Chicago, IL 60620-3854 | 2017-02-15 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS.
| 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.