Univ. of Illinois at Chicago

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

D0030401 Issued in MD

Legal business name

UNIV. OF ILLINOIS AT CHICAGO

Practice address

851 S Morgan St
Seo, MC 063, Room 218
Chicago, IL 60607-7042

Phone

(312) 996-2335

Fax

(312) 996-5921

NPI assigned

Sep 24, 2008

Organization subpart

No

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

Authorized official

Name

Prof. Percival Davis McCormack, M.D.,PH.D.

Title

Professor of Bioengineering

Phone

(312) 996-2335

Specialties & licenses 1

Addresses

Other names 1

• None Other name

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1336399583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 AURORA AVE",
            "address_2": "305",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406221",
            "telephone_number": "630-527-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S MORGAN ST",
            "address_2": "SEO, MC 063, ROOM 218",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606077042",
            "telephone_number": "312-996-2335",
            "fax_number": "312-996-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIV. OF ILLINOIS AT CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "PERCIVAL",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "PROFESSOR OF BIOENGINEERING",
        "authorized_official_telephone_number": "312-996-2335",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "M.D.,PH.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "MD",
            "license": "D0030401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physiological Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Physiological Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.