University of Illinois Chicago

NPI #1720376965 in Chicago, Illinois

Provider Information

NPI Number: 1720376965
Entity Type: Organization
Organization Name: University of Illinois Chicago
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jul 20, 2011
Last Updated: Jul 20, 2011

Practice Location

Address: 1740 WEST TAYLOR STREET,
Address 2: UNIVERSITY OF ILLINOIS
City: Chicago
State: Illinois
ZIP Code: 60612
Phone: (866) 600-2273

Authorized Official

Name: DR. LEELA M PRASAD, MD,FACS,MC,ABCRS
Title: CHIEF OF COLORECTAL SURGERY
Phone: (312) 413-2708

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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