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1740316074 NPI number — THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

NPI Number: 1740316074
Health Care Provider/Practitioner: THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Information about “1740316074” NPI (THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS) exists in 1740316074 in HTML format HTML  |  1740316074 in plain Text format TXT  |  1740316074 in PDF (Portable Document Format) PDF  |  1740316074 in an XML format XML  formats.

NPI Number : 1740316074 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740316074",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
    "ParentOrgTIN": null,
    "OrgName": "THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "840 S WOOD ST",
    "SecondLineMailingAddress": "SUITE 345 CSB, MC 884",
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60612-4325",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "312-355-2035",
    "MailingAddressFaxNumber": "312-355-1916",
    "FirstLinePracticeLocationAddress": "840 S WOOD ST",
    "SecondLinePracticeLocationAddress": "ROOM 163",
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60612-4325",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-996-6887",
    "PracticeLocationAddressFaxNumber": "312-355-1916",
    "EnumerationDate": "02/23/2007",
    "LastUpdateDate": "01/25/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KNORR",
    "AuthorizedOfficialFirstName": "WALTER",
    "AuthorizedOfficialMiddleName": "K",
    "AuthorizedOfficialTitle": "VICE PRESIDENT, CFO, COMPTROLLER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "312-996-8800",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "332B00000X",
        "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
        "LicenseNumber": "93007836",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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