Uic

NPI #1750735759 in Chicago, Illinois

Provider Information

NPI Number: 1750735759
Entity Type: Organization
Organization Name: Uic
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Apr 17, 2016
Last Updated: Apr 17, 2016

Practice Location

Address: 1740 W TAYLOR ST
City: Chicago
State: Illinois
ZIP Code: 60612-7232
Phone: (866) 600-2273

Authorized Official

Name: JASMA MCDONALD
Title: PEDIATRIC DENTAL RESIDENCY
Phone: (256) 606-5080

Specialties & Taxonomy Codes

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

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