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NPI Code Detail

MEDICARE: THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

MEDICARE: THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1780309948
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Provider Business Mailing Address
First Line : 7702 SOLUTION CENTER
Second Line :
City : CHICAGO
State : IL
Zip : 60677-7007
Country : US
Telephone Number : 312-413-3282
Fax Number :
Provider Business Practice Location Address
First Line : 5525 S PULASKI RD STE 150
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4400
Country : US
Telephone Number : 312-492-0060
Fax Number :
Authorized Official
Title or Position : CFO
Name : TIMOTHY STECKER
Credential :
Telephone Number : 312-355-7653
Provider Enumeration Date : 10/10/2022
Last Update Date : 03/13/2026

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Directions to “THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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