The Board of Trustees of the University of Illinois
Organization Active NPI Diagnostic Radiology Physician · Chicago, IL
NPI 1154540607 · NPPES record last updated May 18, 2022
Key facts
- NPI
- 1154540607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
- Practice address
- 1740 W Taylor St
Chicago, IL 60612-7238 - Phone
- (312) 413-4900
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Kailas Sanghani
- Title
- Director of Finance
- Phone
- (312) 413-1350
Other NPIs on the same Medicare enrollment 44
Corporate family (same tax ID) 24
Practitioners 85
-
Saud Suhael Ahmed, M.D.
-
Mohsen Anwar, DO
-
Mark Weldon Arnett, M.D.
-
Ukamaka Atueyi, MD
-
Sonia Bobra, M.D.
-
Michael Bresler, M.D.
-
James Bui, M.D.
-
Anne Darrow, MD
-
Haritha Dukkipati, M.D.
-
Kenneth U Ekechukwu, M.D.
-
Ron C Gaba, MD
-
Lauren Green, M.D.
-
Richard Green, M.D.
-
Kevin L. Keele, M.D.
-
Zia Khan, DO
-
Nael Khayyat, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000158 | IL | Part B Supplier - Clinic/Group Practice | 3072422716 |
Receives reassigned benefits from 2,115 practitioners 44 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Univ of Illinois Hospit
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician |
2085B0100X | |||
| Diagnostic Neuroimaging (Radiology) Physician |
2085D0003X | |||
| Hospice and Palliative Medicine (Radiology) Physician |
2085H0002X | |||
| Neuroradiology Physician |
2085N0700X | |||
| Nuclear Radiology Physician |
2085N0904X | |||
| Pediatric Radiology Physician |
2085P0229X | |||
| Radiation Oncology Physician |
2085R0001X | |||
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Therapeutic Radiology Physician |
2085R0203X | |||
| Vascular & Interventional Radiology Physician |
2085R0204X | |||
| Radiological Physics Physician |
2085R0205X | |||
| Diagnostic Ultrasound Physician |
2085U0001X |
Addresses
Primary practice location
1740 W Taylor St
Chicago, IL 60612-7238
Mailing address
7732 Solution Center
Chicago, IL 60677-3455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01618785 | Other | IL | BCBS GROUP |
| CA5102 | Other | IL | RAILROAD |
Other names
- Dept of Radiology
Other providers in Chicago, IL
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
- The Board of Trustees of the University of Illinois
All providers in Chicago, IL · Diagnostic Radiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.