NPIMap

Organization Active NPI

The Board of Trustees of the University of Illinois

Doing business as Uic Merit

  • Pediatrics Physician
  • Rockford, IL
National Provider Identifier
1972541902
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
Doing business as
Uic Merit
Practice address
2350 N Rockton Ave Ste 204
Rockford, IL 61103-3669
Phone
(815) 395-8812
NPI assigned
Jun 3, 2006
Last updated
Aug 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Loreen Sue Didier
Title
Credentialing Specialist
Phone
(815) 395-5861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2350 N Rockton Ave Ste 204
Rockford, IL 61103-3669

Mailing address

1601 Parkview Ave
Rockford, IL 61107-1822
Phone (815) 395-5861

Other names 1

  • UIC MERIT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000158 IL Part B Supplier - Clinic/Group Practice 3072422716 Receives reassigned benefits from 2,115 practitioners
44 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 44

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

View all 44

National Provider Directory

National Provider Directory
Tax ID family
U of I Opthalmology Dep122 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1640 W Roosevelt Rd
#336
Chicago, IL 60608
Phone (312) 355-4913

1740 W Taylor St
Ste 4E
Chicago, IL 60612

7736 Solutions Ctr
Chicago, IL 60677

840 S Wood St
Ste 130CSN
Chicago, IL 60612

900 Skokie Blvd
Ste 13
Northbrook, IL 60062

2350 N Rockton Ave
Ste 204
Rockford, IL 61103
Phone (815) 395-8812

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1972541902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PARKVIEW AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071822",
            "telephone_number": "815-395-5861",
            "fax_number": "815-395-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N ROCKTON AVE STE 204",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033669",
            "telephone_number": "815-395-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "DIDIER",
        "authorized_official_first_name": "LOREEN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "815-395-5861"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UIC MERIT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.