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General NPI Number Information
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NPI Number | 1023238433
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Entity Type | Organization
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Legal Business Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 912 S WOOD
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City | CHICAGO
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State | IL
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Zip | 60612-7327
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Country | US
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Telephone | 312-996-3496
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Fax |
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Provider Business Mailing Address
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Address Line | 7732 SOLUTION CENTER
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City | CHICAGO
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State | IL
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Zip | 60677-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | KAILAS SANGHANI
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Credential |
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Telephone | 312-413-1350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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