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Contact Information

BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1220 S WOOD ST
ROOM 1045 MC 884
CHICAGO, IL60608-1202
 Phone: 312-413-1767
 Fax: 312-355-1916
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

NPI Number 1790826352
LBN Legal business name BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Authorized official KRISTINE VANKUIKEN - (PHARMACY TECHNICIAN SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2007
Last updated 03/07/2023 - About 3 years ago
Identifiers
IL License # 054.017118
ID Other 1418006 NCPDP NUMBER
IL Other 032-005960 STATE CONTROLLED SUBSTANC
IL Other 093-010041 STATE LICENSE NUMBER
IL Other 054-017118 STATE PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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