Healthcare Provider Details

I. General information

NPI: 1902932825
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: 02/26/2007
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 S WOOD ST RM 1025
CHICAGO IL
60612-3747
US

IV. Provider business mailing address

833 S WOOD ST STE 184E2
CHICAGO IL
60612-7229
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-6540
  • Fax: 312-276-4800
Mailing address:
  • Phone: 312-355-2035
  • Fax: 312-276-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number93009390
License Number StateIL

VIII. Authorized Official

Name: KRISTINE HAYES
Title or Position: PHARMACY TECHNICIAN SPECIALIST
Credential:
Phone: 312-355-2035