NPIMap

Organization Active NPI

University of Illinois SCB Pharmacy

Doing business as University of Illinois Taylor Street EEI Pharmacy

  • Clinic Pharmacy
  • Chicago, IL
National Provider Identifier
1336289016
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
054.017117 Issued in IL
Legal business name
UNIVERSITY OF ILLINOIS SCB PHARMACY
Doing business as
University of Illinois Taylor Street EEI Pharmacy
Practice address
1009 S Wood St
Room 1025 MC 874
Chicago, IL 60612
Phone
(312) 996-6540
Fax
(312) 276-4800
NPI assigned
Feb 8, 2007
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristine Hayes
Title
Pharmacy Technician Specialist
Phone
(312) 355-2035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 054.017117 IL Primary

Addresses

Primary practice location

1009 S Wood St
Room 1025 MC 874
Chicago, IL 60612

Mailing address

833 S Wood St
Room 161 MC 874
Chicago, IL 60612-4325
Phone (312) 355-2035

Other identifiers 3

IdentifierTypeStateIssuer
054-017117OtherILSTATE PHARMACY LICENSE
032-005937OtherILSTATE CONTROLLED SUBSTANC
1464205OtherILNCPDP NUMBER

Other names 1

  • University of Illinois Taylor Street EEI Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Uic Dept of Pathology122 organizations share this tax ID, including this one
Part of
Uic Dept of Pathology

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1855 W Taylor St
Rm 1071
Chicago, IL 60612
Phone (312) 996-6540

833 S Wood St
Rm 161
Chicago, IL 60612

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1336289016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 S WOOD ST",
            "address_2": "ROOM 161 MC 874",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-355-2035",
            "fax_number": "312-276-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 S WOOD ST",
            "address_2": "ROOM 1025 MC 874",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-6540",
            "fax_number": "312-276-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ILLINOIS SCB PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "PHARMACY TECHNICIAN SPECIALIST",
        "authorized_official_telephone_number": "312-355-2035"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "IL",
            "license": "054.017117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "054-017117",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CONTROLLED SUBSTANC",
            "identifier": "032-005937",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "1464205",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Illinois Taylor Street EEI Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.