BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1801 W Taylor St Room 309 Mc 884
Chicago, IL 60612
312-996-8675
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | IL | 054-017119 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP NUMBER | 1453391 | IL | OTHER |
STATE LICENSE | 054-017119 | IL | OTHER |
STATE CONTROLLED SUBSTANC | 032-006004 | IL | OTHER |
DEA NUMBER | BU4646533 | IL | OTHER |