MEDICARE: UNIVERSITY OF CHICAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital		IL

General Provider Information

NPI Number	:	1720191653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF CHICAGO

Provider Business Mailing Address
First Line	:	5841 S MARYLAND AVE # 2115
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1447
Country	:	US
Telephone Number	:	773-702-4601
Fax Number	:	773-834-0188

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE # 2115
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1447
Country	:	US
Telephone Number	:	773-702-4601
Fax Number	:	773-834-0188

Authorized Official
Title or Position	:	ASSOCIATE PROFESSOR OF MEDICINE
Name	:	DR. THOMAS FRANK GAJEWSKI
Credential	:	M.D., PH.D.
Telephone Number	:	773-702-4601

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	08/22/2020

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Directions to “UNIVERSITY OF CHICAGO ” Practice Location

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