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General NPI Number Information
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NPI Number | 1942404850
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF ILLINOIS HOSPITAL
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1740 W TAYLOR ST
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City | CHICAGO
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State | IL
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Zip | 60612-7232
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Country | US
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Telephone | 312-996-8039
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Fax |
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Provider Business Mailing Address
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Address Line | 110 N KENILWORTH AVE APT 5D
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City | OAK PARK
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State | IL
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Zip | 60301-1217
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Country | US
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Telephone | 708-524-0936
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Fax |
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Authorized Official
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Title or Position | DIRECTOR BUSINESS OPERATIONS
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Name | MRS. JEAN FITZPATRICK
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Credential | MPA
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Telephone | 312-413-3922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State | IL
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