THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1407307812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407307812 |
| Entity Type | Organization |
| Organization Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Other Organization Name | UIC HEALTHSPAN FACULTY PRACTICE |
| Practice Address |
1640 W Roosevelt Rd Room 336 Chicago IL 60608-1316 |
| Mailing Address |
1919 W Taylor St 650 Ahsb Chicago IL 60612-7246 |
| Practice Telephone | 3124138043 |
| Mailing Telephone | 3129964404 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |
| Authorized Official Name | DR. BO FERNHALL (DEAN, APPLIED HEALTH SCIENCES) |
| Authorized Official Telephone | 3129966695 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UIC Healthspan Faculty Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| 1043727571 | The Board of Trustees of The University of Illinois | Clinic/Center | 835 S. Wolcott, Suite E-144; Mc 684, Chicago, IL 60612 | 2018-01-05 |
| 1871905190 | The Board of Trustees of The University of Illinois | Clinic/Center | 840 Blackhawk Blvd, South Beloit, IL 61080-2263 | 2014-05-21 |
| 1841614609 | The Board of Trustees of The University of Illinois | Clinic/Center | 3240 W Division St, Chicago, IL 60651-2405 | 2014-02-13 |
| 1932450160 | The Board of Trustees of The University of Illinois | Clinic/Center | 3050 W 39th Pl, Chicago, IL 60632-2402 | 2012-09-27 |
| 1346596327 | The Board of Trustees of The University of Illinois | Clinic/Center | 641 W. 63rd St, Uih-mile Square Health Center At Englewood, Chicago, IL 60621-2032 | 2012-07-27 |
| 1407166671 | The Board of Trustees of The University of Illinois | Clinic/Center | 4747-51 West Cermak Rd, Uih-mile Square Health Center At Cicero, Cicero, IL 60804-2508 | 2010-10-20 |
| 1659501500 | The Board of Trustees of The University of Illinois | Durable Medical Equipment & Medical Supplies | 811 S Paulina St, 118 Dent, Mc 588, Chicago, IL 60612-4353 | 2009-07-24 |
| 1518194364 | The Board of Trustees of The University of Illinois | Clinic/Center | 1231 S Damen Ave, Chicago, IL 60608-1145 | 2009-06-19 |
| 1457523219 | The Board of Trustees of The University of Illinois | Clinic/Center | 4630 South Bishop Street, Uih-mile Square Health Center At Back of The Yards, Chicago, IL 60609-3240 | 2008-04-01 |
| Street Address |
1640 W ROOSEVELT RD ROOM 336 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60608-1316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174554331 | University of Illinois - Chicago | Developmental Therapist | 1640 W Roosevelt Rd, Room 336 (mc 628), Chicago, IL 60608-1316 | 2006-07-06 |
| 1821608597 | Amanda J Montbriand | Physical Therapist | 1640 W Roosevelt Rd, Chicago, IL 60608-1316 | 2020-08-06 |
| 1285244947 | Benjamin Land | Physical Therapist | 1640 W Roosevelt Rd, Chicago, IL 60608-1316 | 2020-08-06 |
| 1750925111 | Marcus Williams | Occupational Therapy Assistant | 1640 W Roosevelt Rd, Chicago, IL 60608-1316 | 2019-10-29 |
| 1558883033 | Heidi Fischer | Occupational Therapist | 1640 W Roosevelt Rd, Chicago, IL 60608-1316 | 2017-07-17 |
| 1841728458 | Carlyn Dorothy Babinec | Physical Therapist | 1640 W Roosevelt Rd, Chicago, IL 60608-1316 | 2017-05-25 |
| 1568815421 | Uic Assistive Technology Unit | Speech-Language Pathologist | 1640 W Roosevelt Rd, 415, Chicago, IL 60608-1316 | 2016-07-15 |
| 1295185072 | Stephanie Vallera Bay | Speech-Language Pathologist | 1640 W Roosevelt Rd, 415, Chicago, IL 60608-1316 | 2016-06-13 |
| 1386099539 | Fani Lee | Occupational Therapist | 1640 W Roosevelt Rd, Rm 413, Chicago, IL 60608-1316 | 2016-04-25 |
| 1679981955 | Cara Vaccarello | Psychologist | 1640 W Roosevelt Rd, Room 114, Chicago, IL 60608-1316 | 2014-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390047 | Bethuna Shields | Occupational Therapist | 1401 South California Ave, Chicago, IL 60608 | 2020-06-11 |
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1205481058 | Joshua Hartman | Pharmacist | 345 Csb Mc 884, 840 S. Wood St, Chicago, IL 60608 | 2019-08-08 |
| 1194386706 | Mount Sinai Hospital, Chicago | Internal Medicine | Mount Sinai Hospital, 1500 S Fairfield Ave, Chicago, IL 60608 | 2019-06-25 |
| 1841754256 | Julia Bates | Occupational Therapist | 1640 W. Roosevelt Rd., 415 Dhsp (mc 726), Chicago, IL 60608 | 2019-01-30 |
| 1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
| 1114412970 | Dmitri Zbarsky | Internal Medicine | 1500 South Fairfield Ave., F-914, Chicago, IL 60608 | 2018-06-25 |
| 1740773050 | Alexia Ilian Derma Salazar | Speech-Language Pathologist | 2301 W 19th St - 3rd Floor Rear, Chicago, IL 60608 | 2018-06-11 |
| 1912424730 | Pareen Modi | Pharmacist | 2539 South Western Avenue, Chicago, IL 60608 | 2017-08-23 |
| 1952824302 | Raquel Gonzalez Heredia | Surgery | 1500 South Fairfield Ave, Chicago, IL 60608 | 2017-07-18 |
| Find all providers in zip 60608 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569064 | Boss Povieng | Physical Medicine & Rehabilitation | 1620 W Harrison St Ste 403, Chicago, IL 60612-3801 | 2020-05-15 |
| 1205488590 | Michelle E Roberts | Physical Medicine & Rehabilitation | 225 S Sangamon St Ste 1, Chicago, IL 60607-5167 | 2019-07-16 |
| 1750849428 | Ovation Hand Institute, LLC | Physical Medicine & Rehabilitation | 737 N Michigan Ave Ste 2200, Chicago, IL 60611-6750 | 2019-03-12 |
| 1467921080 | John Nestle Eslofor Galan | Physical Medicine & Rehabilitation | 5752 N Austin Ave # 2n, Chicago, IL 60646-6231 | 2018-11-14 |
| 1437689809 | Lauren E Woo | Physical Medicine & Rehabilitation | 355 E Erie St Ste 21-2128, Chicago, IL 60611-3167 | 2017-06-18 |
| 1245761899 | Kevin Machino | Physical Medicine & Rehabilitation | 1401 S California Ave Ste 1, Chicago, IL 60608-1694 | 2017-03-24 |
| 1497102297 | Andrew J Patton | Physical Medicine & Rehabilitation | 1725 W Harrison St Ste 1018, Chicago, IL 60612-3835 | 2016-05-21 |
| 1437512886 | Kevin Huang | Physical Medicine & Rehabilitation | 345 E Superior St Ste 1600, Chicago, IL 60611-2654 | 2016-04-02 |
| 1497128524 | Sara R Rodriguez | Physical Medicine & Rehabilitation | 806 W Washington Blvd, Suite 203 B-d, Chicago, IL 60607-2338 | 2015-11-11 |
| 1275918112 | Avant -garde Medicne Sc | Physical Medicine & Rehabilitation | 215 W Washington St Apt 5006, Chicago, IL 60606-3543 | 2015-07-21 |
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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.