Healthcare Provider Details

I. General information

NPI: 1073552022
Provider Name (Legal Business Name): THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

1740 W TAYLOR ST # MC693
CHICAGO IL
60612-7232
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax: 312-996-1001
Mailing address:
  • Phone: 312-996-3620
  • Fax: 312-996-0850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. LAURENCE APPEL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 312-996-3620