BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS (NPI# 1952552101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952552101 |
| Entity Type | Organization |
| Organization Name | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Other Organization Name | UIMC REFERENCE LAB PROFESSIONAL GROUP |
| Practice Address |
840 S Wood St Room 170 (mc 750) Chicago IL 60612-4325 |
| Practice Telephone | 3123555800 |
| Practice Fax Number | 3129968261 |
| Mailing Telephone | 3123555800 |
| Mailing Fax Number | 3129968261 |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |
| Authorized Official Name | WALTER K KNORR (VICE PRESIDENT, CHIEF FINANCIAL OFF) |
| Authorized Official Telephone | 3129968800 |
| Is Organization Subpart | Y |
| Parent Organization Name | BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZB0001X |
Pathology Specialization: Blood Banking & Transfusion Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZF0201X |
Pathology Specialization: Forensic Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZH0000X |
Pathology Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZI0100X |
Pathology Specialization: Immunopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZM0300X |
Pathology Specialization: Medical Microbiology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZN0500X |
Pathology Specialization: Neuropathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0007X |
Pathology Specialization: Molecular Genetic Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0104X |
Pathology Specialization: Chemical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0213X |
Pathology Specialization: Pediatric Pathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207ZC0006X |
Pathology Specialization: Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UIMC Reference Lab Professional Group | Doing Business As Name - 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 |
840 S WOOD ST ROOM 170 (MC 750) |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-4325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354656 | Frederick G. Behm | Pathology | 840 S Wood St, Department of Pathology, Mc847, Chicago, IL 60612-4325 | 2005-05-23 |
| 1467065581 | Monica Joan Gingell | Nurse Practitioner | 840 S Wood St, Chicago, IL 60612-4325 | 2020-08-28 |
| 1003435926 | Kyle Corso Mork | Pharmacist | 840 S Wood St, Chicago, IL 60612-4325 | 2020-04-10 |
| 1841828282 | Hovig Chelebian | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2020-03-31 |
| 1417585787 | Mehul Gilani | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2020-03-31 |
| 1730736356 | Alice Zalan | Genetic Counselor, MS | 840 S Wood St, Chicago, IL 60612-4325 | 2019-08-19 |
| 1972155547 | Lenika De Simone | Genetic Counselor, MS | 840 S Wood St, Chicago, IL 60612-4325 | 2019-07-12 |
| 1528629961 | Melissa Duckett | Nurse Practitioner | 840 S Wood St, Chicago, IL 60612-4325 | 2019-06-26 |
| 1629631098 | Jonathan Alverio | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2019-04-20 |
| 1225598766 | Daphne Porat | Student in an Organized Health Care Education/Training Program | 840 S Wood St, Chicago, IL 60612-4325 | 2019-03-21 |
| 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 | 207ZC0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic "clinical pathology only" route. Board Certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902416936 | Chicago Lab Services Inc | Pathology | 7422 N Western Ave Ste 1, Chicago, IL 60645-1707 | 2020-08-04 |
| 1063927572 | Elite Pathology Lab Inc | Pathology | 3744 W North Ave, Chicago, IL 60647-4727 | 2017-12-06 |
| 1467922005 | St Bernard Hospital & Health Care Center | Pathology | 326 W 64th St, Chicago, IL 60621-3114 | 2018-11-27 |
| 1679003446 | Joseph Cho | Pathology | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2017-06-14 |
| 1164878195 | Angelica Moran | Pathology | 5841 S Maryland Ave # 3083, Chicago, IL 60637 | 2016-05-09 |
| 1154639771 | Peng Ji | Pathology | 420 E Superior St, Rubloff Building 12-172, Chicago, IL 60611-4494 | 2010-09-16 |
| 1457532822 | Solaris Diagnostics PC | Pathology | 3538 W Fullerton Ave, Chicago, IL 60647-2443 | 2007-11-14 |
| 1366631533 | Karen M Frank | Pathology | 5841 S Maryland Ave, Mc 0001, Chicago, IL 60637-1447 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023658416 | Haneefah Maryam Cummings | Pathology | 7360 N Lincoln Ave Ste 110, Lincolnwood, IL 60712-1705 | 2020-01-14 |
| 1245487610 | Mohammed Khairy Atieh | Pathology | 2160 S 1st Ave, Building 110, Maywood, IL 60153-3328 | 2008-08-27 |
| 1619133717 | Saeedeh Masoom | Pathology | 2520 Elisha Ave, Zion, IL 60099-2676 | 2008-07-29 |
| 1295905297 | Clinical Pathology Associates, Sc | Pathology | 1225 W Lake St, Melrose Park, IL 60160-4039 | 2008-03-05 |
| 1609044981 | Oak Park Clinical Pathologists, P.C. | Pathology | 3 Erie Ct, Oak Park, IL 60302-2519 | 2008-02-20 |
| 1013134402 | Jason Kang | Pathology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2007-04-19 |
Please comment or provide details below to improve the information on BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS.
| 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.