BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1265651434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265651434 |
Entity Type | Organization |
Organization Name | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
Other Organization Name | UIC DEPT OF DERMATOLOGY |
Practice Address |
808 S Wood St Chicago IL 60612-7300 |
Mailing Address |
135 S La Salle St Dept 3450 Chicago IL 60674-3450 |
Practice Telephone | 3129966966 |
Enumeration Date | 2007-04-25 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. WILLIAM R NICHOLAS (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3124131350 |
Authorized Official Credential | PH.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | RAILROAD GROUP | CG9096 | 01 |
IL | BCBS GROUP | 01618685 | 01 |
Other Name | Type Code |
---|---|
UIC Dept of Dermatology | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720555147 | Board of Trustees of The University of Illinois | Case Management | 3014 W 39th Pl, Chicago, IL 60632-2402 | 2018-10-24 |
1447390125 | Board of Trustees of The University of Illinois | Pharmacy | 722 W Maxwell St, Room 205 Mc 184, Chicago, IL 60607-5002 | 2007-02-08 |
1790704484 | Board of Trustees of The University of Illinois | Clinic/Center | 1059 W 13th St, Chicago, IL 60608-1526 | 2006-07-19 |
1467425322 | Board of Trustees of The University of Illinois | Internal Medicine | Medical Service Plan, One Illini Dr, Peoria, IL 61656 | 2006-02-10 |
1790252047 | Board of Trustees of The University of Illinois | Case Management | 55 W Cermak Rd, Chicago, IL 60616-2001 | 2018-10-25 |
1295202554 | Board of Trustees of The University of Illinois | Case Management | 1628 W Washington Blvd, Chicago, IL 60612-2613 | 2018-10-25 |
1972070225 | Board of Trustees of The University of Illinois | Case Management | 2641 S Calumet Ave, Chicago, IL 60616-2901 | 2018-10-25 |
1720554264 | Board of Trustees of The University of Illinois | Case Management | 1220 S Wood St, Chicago, IL 60608-1202 | 2018-10-23 |
1770059156 | Board of Trustees of The University of Illinois | Case Management | 8131 S May St, Chicago, IL 60620-3007 | 2018-10-23 |
1558837922 | Board of Trustees of The University of Illinois | Case Management | 641 W 63rd St, Chicago, IL 60621-2032 | 2018-10-23 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | 809 S Marshfield Ave Rm214, Chicago, IL 60612-4305 |
System for Award Management (SAM) Entities | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS, THE | 364 Henry Administration Bldg, Urbana, IL 61801 |
Street Address |
808 S WOOD ST |
City | CHICAGO |
State | IL |
Zip Code | 60612-7300 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598767410 | Trevonne M. Thompson | Emergency Medicine | 808 S Wood St, Mc724, Chicago, IL 60612-7300 | 2005-08-11 |
1063047009 | Sherin Mahrat | Student in an Organized Health Care Education/Training Program | 808 S Wood St, Chicago, IL 60612-7300 | 2020-03-10 |
1154828879 | Francis Villanueva | Emergency Medicine | 808 S Wood St, Chicago, IL 60612-7300 | 2018-04-09 |
1134624505 | Taryn Murray | Student in an Organized Health Care Education/Training Program | 808 S Wood St, Chicago, IL 60612-7300 | 2018-03-28 |
1336503226 | Patrick Owen Mccaffrey | Emergency Medicine | 808 S Wood St, M/c 724, Chicago, IL 60612-7300 | 2016-04-07 |
1710366968 | Sal Manuel Sebastian Calo | Internal Medicine | 808 S Wood St, 469 Cme, M/c 724, Chicago, IL 60612-7300 | 2015-05-20 |
1649615733 | Annie-laurie Auden | Student in an Organized Health Care Education/Training Program | 808 S Wood St, 469 Cme, M/c 724, Chicago, IL 60612-7300 | 2013-05-03 |
1548587504 | Katherine Bayer | Emergency Medicine | 808 S Wood St, 469 Cme, M/c 724, Chicago, IL 60612-7300 | 2010-04-29 |
1114153475 | David Charles Snow | Emergency Medicine | 808 S Wood St, Room 471, Chicago, IL 60612-7300 | 2009-06-01 |
1144476516 | Seema Awatramani | Emergency Medicine | 808 S Wood St, Chicago, IL 60612-7300 | 2008-08-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
Find all providers in zip 60612 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
1891257853 | Maria Estela Martinez Escala | Dermatology | 5841 S Maryland Ave Ste Mc5067, Chicago, IL 60637-1443 | 2019-04-01 |
1275013450 | Advanced Dermatology and Aesthetic Medicine | Dermatology | 850 S Wabash Ave Ste 200, Chicago, IL 60605-3642 | 2018-08-17 |
1346784543 | Dermio, LLC | Dermatology | 3023 N Clark St, Suite 861, Chicago, IL 60657-5200 | 2016-12-07 |
1366823544 | Oyinade Aderibigbe | Dermatology | 111 W Washington St Ste 1801, Chicago, IL 60602-3430 | 2015-06-14 |
1073909032 | Julia Dai | Dermatology | 5758 S Maryland Ave Fl 3, Chicago, IL 60637 | 2015-04-07 |
1437544582 | Nicholas Blickenstaff | Dermatology | 30 N Michigan Ave Ste 1429, Chicago, IL 60602-3698 | 2015-04-04 |
1801285929 | Medical Dermatology Associates of Chicago, Ltd | Dermatology | 363 W Erie St, Suite 350, Chicago, IL 60654-6903 | 2015-01-13 |
1366857286 | Noor Tazudeen | Dermatology | 4700 N Marine Dr Ste 220, Chicago, IL 60640-7972 | 2014-06-30 |
Find all providers in CHICAGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.