Graduated: 2022
NPI: 1700570413
Practice Locations (2)
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1740 W TAYLOR ST
CHICAGO, IL 606127232
3123554000
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
912 S WOOD ST
CHICAGO, IL 606124300
3123556468
Source: CMS National Downloadable File, September 2026.