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General NPI Number Information
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NPI Number | 1497907786
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CHICAGO
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE # MC3077
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City | CHICAGO
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State | IL
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Zip | 60637-1447
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Country | US
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Telephone | 773-702-6751
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Fax |
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Provider Business Mailing Address
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Address Line | 180 HARVESTER DR STE 110
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City | BURR RIDGE
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State | IL
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Zip | 60527-6686
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Country | US
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Telephone | 773-834-1061
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Fax | 773-834-0946
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MS. ZORAYA VELAZQUEZ
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Credential |
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Telephone | 773-834-1061
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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 | 036051478
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License Number State | IL
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