Healthcare Provider Details

I. General information

NPI: 1376489229
Provider Name (Legal Business Name): BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 W ROOSEVELT RD RM 338
CHICAGO IL
60608-1316
US

IV. Provider business mailing address

1740 W. TAYLOR HOSPITAL ADMIN MAILCODE 693
CHICAGO IL
60612-7232
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-6480
  • Fax:
Mailing address:
  • Phone: 312-996-3620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

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