The Board of Trustees of University of Illinois

Primary specialty

AmbulanceTaxonomy code 341600000X

License

11 8150 Issued in IL

Legal business name

THE BOARD OF TRUSTEES OF UNIVERSITY OF ILLINOIS

Doing business as

UIC Emergency Medical Services

Practice address

1129 S Hermitage Ave
Room 101
Chicago, IL 60612

Phone

(312) 355-4367

NPI assigned

Feb 1, 2013

Last updated

Feb 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Martin Roy Walsh, BS, NRPNPI 1598123481

Title

EMS Administrator

Phone

(312) 355-4367

Specialties & licenses 1

Addresses

Other names 1

• UIC Emergency Medical Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Martin Walsh

  • Basic Emergency Medical Technician
  • Elmhurst, IL
  • NPI 1598123481
  NPD (past) Authorized official

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1336488055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1368",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601268368",
            "telephone_number": "630-530-2988",
            "fax_number": "630-832-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 S HERMITAGE AVE",
            "address_2": "ROOM 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-355-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BOARD OF TRUSTEES OF UNIVERSITY OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-01",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "EMS ADMINISTRATOR",
        "authorized_official_telephone_number": "312-355-4367",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, NRP"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "11 8150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UIC Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Board of Trustees of the University of Illinois (University of Illinois Medical Center at Chicago)
• The Board of Trustees of the University of Illinois (Mile Square Auburn Gresham Health and Wellness Center)
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of University of Illinois (UI Health Wellness Clinic at Altus Academy)
• The Boulevard of Chicago
• The Boulevard of Chicago
• The Branch Family Institute, Inc.
• The Breakers at Edgewater Beach
• The Catalyst Collaborative, LLC

• Ambulance in Chicago, IL
• Providers in Chicago, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.