MEDICARE: THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207V00000X	Obstetrics & Gynecology Physician
2	207W00000X	Ophthalmology Physician
3	207L00000X	Anesthesiology Physician
4	207N00000X	Dermatology Physician
5	207P00000X	Emergency Medicine Physician
6	207Q00000X	Family Medicine Physician
7	207T00000X	Neurological Surgery Physician
8	207X00000X	Orthopaedic Surgery Physician
9	207ZP0101X	Anatomic Pathology Physician
10	208000000X	Pediatrics Physician
11	2085R0001X	Radiation Oncology Physician
12	2085R0202X	Diagnostic Radiology Physician
13	208600000X	Surgery Physician
14	208800000X	Urology Physician
15	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1134118649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Provider Business Mailing Address
First Line	:	7732 SOLUTION CENTER
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 S. PAULINA STREET
Second Line	:	MC 621
City	:	CHICAGO
State	:	IL
Zip	:	60612-7212
Country	:	US
Telephone Number	:	312-355-6245
Fax Number	:	312-996-8422

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MS. VICTORIA MARIE LEVITSKE
Credential	:	MPM
Telephone Number	:	312-996-0566

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	01/16/2020

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Directions to “THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS ” Practice Location

Language	Start Address	Practice Location

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