The Board of Trustees of the University of Illinois

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

93013079 Issued in IL

Legal business name

THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Practice address

1801 W Taylor St
Suite 3E
Chicago, IL 60612-4319

Phone

(312) 996-8675

Fax

(312) 355-2888

NPI assigned

Feb 26, 2007

Organization subpart

Yes

Parent organization

BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOISAs reported in NPPES

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

Authorized official

Name

Walter K Knorr

Title

Vice President, Cfo, Comptroller

Phone

(312) 996-8800

Specialties & licenses 1

Addresses

Other names 1

• University of Illinois Dermatology Pharmacy Doing business as

Part of

Univ of Illinois Hospit

Locations

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1740316660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "SUITE 345 CSB, MC 884",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-2812",
            "fax_number": "312-355-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "address_2": "SUITE 3E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124319",
            "telephone_number": "312-996-8675",
            "fax_number": "312-355-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
        "enumeration_date": "2007-02-26",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "KNORR",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VICE PRESIDENT, CFO, COMPTROLLER",
        "authorized_official_telephone_number": "312-996-8800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "93013079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Illinois Dermatology Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois
• The Board of Trustees of the University of Illinois

• All providers in Chicago, IL
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.