UNIVERSITY OF ILLINOIS (NPI# 1962631010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962631010 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF ILLINOIS |
| Practice Address |
1747 W Roosevelt Rd Chicago IL 60608-1264 |
| Practice Telephone | 3124131741 |
| Mailing Telephone | 3124131741 |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2009-07-10 |
| Authorized Official Name | MARISELA HUERTA (VISITING STAFF PSYCHOLOGIST) |
| Authorized Official Telephone | 3124131741 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071007706 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659431351 | University of Illinois | Public Health or Welfare | 2815 W Washington, Suite 300, Springfield, IL 62794-9481 | 2006-12-11 |
| 1861409450 | University of Illinois | Audiologist | 2001 S Oak St Ste B, Champaign, IL 61820-0912 | 2006-08-03 |
| 1962475996 | University of Illinois | Obstetrics & Gynecology | Dept. of Ob / Gyn, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-09 |
| 1174596225 | University of Illinois | Pediatrics | 515 Ne Glen Oak Ave, Pediatric Neurology, Peoria, IL 61603-3165 | 2006-02-09 |
| 1245203280 | University of Illinois | Psychiatry & Neurology | Department of Psychiatry, 221 Ne Glen Oak 7 West, Peoria, IL 61636-0001 | 2006-02-09 |
| 1568433050 | University of Illinois | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-01 |
| 1619948411 | University of Illinois | Pediatrics | Regional Development Center, 507 E Armstrong, Peoria, IL 61603 | 2006-01-30 |
| 1275817249 | University of Illinois | General Acute Care Hospital | 611 W Park St, Carle Forum, Urbana, IL 61801-2500 | 2011-10-07 |
| 1871725028 | University of Illinois | Internal Medicine | 840 S Wood St, Department of Medicine, M/c 787, Chicago, IL 60612-4325 | 2009-08-20 |
| 1205002185 | University of Illinois | General Acute Care Hospital | 611 W Park St, Carle Forum Lower Level, Urbana, IL 61801-2500 | 2008-05-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF ILLINOIS | 809 S Marshfield 9th Flr, Chicago, IL 60612-4305 |
| Virginia Business Entities | UNIVERSITY OF ILLINOIS ALUMNI CLUB OF GREATER WASHINGTON D.C. | 147 D St Se, Washington, District Of Columbia 20003 |
| Oklahoma Business Registrations | UNIVERSITY OF ILLINOIS FOUNDATION | 1305 West Green St, Urbana, IL 61801 |
| System for Award Management (SAM) Entities | UNIVERSITY OF ILLINOIS RESEARCH PARK, LLC | 60 Hazelwood Dr, Champaign, IL 61820-7460 |
| Street Address |
1747 W ROOSEVELT RD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60608-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497767719 | Elizabeth Charney | Psychiatry & Neurology | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2006-08-13 |
| 1932768272 | Mary Elizabeth Bunn | Social Worker | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2019-06-11 |
| 1942786934 | Alexandra Bernard | Psychologist | 1747 W Roosevelt Rd, Chicago, IL 60608 | 2018-07-13 |
| 1417485525 | Aishah Yanssaneh | Psychiatry & Neurology | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2017-06-02 |
| 1053855098 | Julia Wenzlaff | Social Worker | 1747 W Roosevelt Rd, 155 Ijr, Chicago, IL 60608-1264 | 2016-12-09 |
| 1922452408 | Sonya Mohan | Psychiatry & Neurology | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2016-04-20 |
| 1053799015 | Dana Rusch | Psychologist | 1747 W Roosevelt Rd, Institute for Juvenile Research, Colbeth Clinic, Chicago, IL 60608-1264 | 2015-05-11 |
| 1407277122 | Tara Mehta | Psychologist | 1747 W Roosevelt Rd, 155 Worb, Chicago, IL 60608-1264 | 2013-12-23 |
| 1942580766 | Sally M. Weinstein | Psychologist | 1747 W Roosevelt Rd, Rm 187, First Floor, Chicago, IL 60608-1264 | 2011-08-24 |
| 1205125473 | Kelley Alma Volpe | Psychiatry & Neurology | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2011-03-28 |
| 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 | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| 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.