NPIMap

The Board of Trustees of the University of Illinois

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Chicago, IL

NPI 1609822147 · NPPES record last updated Aug 31, 2026

Key facts

NPI
1609822147
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Practice address
912 S Wood St
Chicago, IL 60612-4300
Phone
(312) 413-3783
Fax
(312) 996-3514
NPI assigned
May 26, 2006
Organization subpart
No

Authorized official

Name
Silvia Avila
Title
Director of Revenue Cycle
Phone
(312) 413-7590

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1,190

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,190

Medicare participation

Medicare fee-for-service enrollment
Enrolled (4 enrollments) in IL

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Illinois Hospital and Clinics
Chicago, IL · CCN 140150		 Hospital Operational/Managerial Control (100%) Jul 1, 1966
University of Illinois Hospital
Chicago, IL · CCN 14S150		 Hospital Operational/Managerial Control (100%) Jul 1, 1966
Uimcc MSHC at South Shore
Chicago, IL · CCN 141028		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2012
Uic Mile Square Health Center
Chicago, IL · CCN 141896		 Federally qualified health center Operational/Managerial Control (100%) Jul 2, 2012
Mile Square Back of the Yards
Chicago, IL · CCN 141074		 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Apr 10, 2008
Uic-Mile Square at Cicero
Cicero, IL · CCN 141161		 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Nov 10, 2010
University of Illinois - Mile Square Health Center Englewood
Chicago, IL · CCN 141175		 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jul 2, 2012
Mile Square Davis Health and Wellness Center
Chicago, IL · CCN 781842		 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
The Board of Trustees of the University of Illinois
Rockford, IL · CCN 781936		 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 9, 2020
May 9, 2020
Ui Health Mile Square Health Center Primary and Immediate Care Center
Chicago, IL · CCN 781070		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2022
Ui Health Mile Square Health Center Back of the Yards Dental
Chicago, IL · CCN 781067		 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031126000262 IL Part B Supplier - Clinic/Group Practice 3072422716 Receives reassigned benefits from 12 practitioners
Practice locations: Chicago, IL
O20031201000230 IL Part B Supplier - Clinic/Group Practice 3072422716 Receives reassigned benefits from 48 practitioners
1 other NPI on this enrollment
Practice locations: Chicago, IL; Rockford, IL
O20040128001061 IL Part B Supplier - Clinic/Group Practice 3072422716 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
Practice locations: Chicago, IL
O20040720000978 IL Part B Supplier - Clinic/Group Practice 3072422716 Receives reassigned benefits from 10 practitioners
Practice locations: Chicago, IL

National Provider Directory

Tax ID family
Univ of Illinois Hospit (122 organizations share this tax ID)

Locations

801 S Paulina St
Chicago, IL 60612
Phone (312) 996-1052

1740 W Taylor St
Rm 2178
Chicago, IL 60612

835 S Wolcott Ave
#W140
Chicago, IL 60612

5225 W Madison St
Chicago, IL 60644
Phone (773) 379-1137

2710 S Dearborn St
Chicago, IL 60616
Phone (312) 355-5745

734 W 47th St
Chicago, IL 60609
Phone (773) 536-8400

1255 W 18th St
Chicago, IL 60608
Phone (773) 622-6218

135 S La Salle St
Chicago, IL 60603

7131 S Jeffery Blvd
Chicago, IL 60649
Phone (773) 256-0526

1606 W 63rd St
Chicago, IL 60636
Phone (312) 519-5526

4634 S Bishop St
Chicago, IL 60609
Phone (312) 355-5570

1425 N Hunt Club Rd
Gurnee, IL 60031
Phone (847) 548-2200

1800 N Knoxville Ave
Ste C
Peoria, IL 61603
Phone (309) 624-9680

420 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 655-2343

444 Roxbury Rd
#12471
Rockford, IL 61107

5668 E State St
Rockford, IL 61108
Phone (815) 229-7580

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103G00000X
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103TC0700X
Clinical Child & Adolescent Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103TC2200X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 1041C0700X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X
Addiction Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0802X
Child & Adolescent Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0804X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LP0808X

Addresses

Primary practice location

912 S Wood St
Chicago, IL 60612-4300

Mailing address

7825 Solution Center
Chicago, IL 60677-7008
Phone (312) 996-7383

Other practice location 1

1747 W Roosevelt Rd
Chicago, IL 60608-1264
Phone (312) 996-2200

Other practice location 2

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Other identifiers

IdentifierTypeStateIssuer
203465OtherILMEDICARE APN/CNS
01618662OtherILBLUE CROSS BLUE SHIELD

Other names

  • Department of Psychiatry Doing business as
  • UIC DEPARTMENT OF PSYCHIATRY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2026.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1609822147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 SOLUTION CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606777008",
            "telephone_number": "312-996-7383",
            "fax_number": "312-996-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300",
            "telephone_number": "312-413-3783",
            "fax_number": "312-996-3514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 W Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081264",
            "country_code": "US",
            "telephone_number": "312-996-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "SILVIA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "312-413-7590"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE APN/CNS",
            "identifier": "203465",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01618662",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UIC DEPARTMENT OF PSYCHIATRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

All providers in Chicago, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

Sources for this page

Verify at the official NPI Registry.