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Nursing Facility Supplies, Customized Equipment

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BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS

Medical Equipment Supplier Yellow Pages

Chicago, Illinois

Provider NPI: 1336289016

Organization Information:
Organization Name:  BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS


Practice Location:
1855 W TAYLOR ST ROOM 1071 MC 884 CHICAGO, IL 60612 US
Tel: 312-996-6540  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336C0002XSuppliers
Pharmacy
Clinic Pharmacy
IL054.017117

Other Provider Identifiers:

IssuerNumberStateType
STATE PHARMACY LICENSE054-017117IL01
NCPDP NUMBER1464205IL01
STATE CONTROLLED SUBSTANC032-005937IL01
DEA NUMBERBU1635917IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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