NPIMap

Organization Active NPI

Board of Trustees Fo the University of Illinois

  • Case Management Agency
  • Chicago, IL
National Provider Identifier
1578039939
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
BOARD OF TRUSTEES FO THE UNIVERSITY OF ILLINOIS
Practice address
4630 S Bishop St
Chicago, IL 60609-3240
Phone
(773) 579-9401
NPI assigned
Oct 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
Mr. Henry Taylor
Title
Ceo
Phone
(312) 413-1261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

4630 S Bishop St
Chicago, IL 60609-3240

Mailing address

1220 S Wood St
Chicago, IL 60608-1202
Phone (312) 413-1261

Other identifiers 1

IdentifierTypeStateIssuer
1622185OtherBCBS PROVIDER

Other names 1

  • UIH-Mile Square Health Center at Back of the Yards IHH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Univ of Illinois Hospit122 organizations share this tax ID, including this one

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

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1578039939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081202",
            "telephone_number": "312-413-1261",
            "fax_number": "312-413-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 S BISHOP ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093240",
            "telephone_number": "773-579-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF TRUSTEES FO THE UNIVERSITY OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-413-1261",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "1622185",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UIH-Mile Square Health Center at Back of the Yards IHH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UIH-Mile Square Health Center at Back of the Yards IHH",
            "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 Oct 25, 2018; 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.