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General NPI Number Information
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NPI Number | 1003071812
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF ILLINOIS AT CHICAGO
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 912 S WOOD ST
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City | CHICAGO
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State | IL
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Zip | 60612-4300
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Country | US
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Telephone | 312-996-5754
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Fax | 312-355-3581
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Provider Business Mailing Address
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Address Line | 1737 W POLK ST
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City | CHICAGO
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State | IL
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Zip | 60612-7224
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Country | US
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Telephone | 312-996-2882
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Fax |
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Authorized Official
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Title or Position | INTERIM VICE CHANCELLOR (RESEARCH)
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Name | DR. LARRY DANZIGER
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Credential | DPHARM
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Telephone | 312-996-2862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 036.046533
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License Number State | IL
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