BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1801 W Taylor St Room 3003 Mc 884
Chicago, IL 60612
312-996-9058
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | IL | 054.017121 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP NUMBER | 1481186 | IL | OTHER |
STATE PHARMACY LICENSE | 054-017121 | IL | OTHER |
STATE CONTROLLED SUBSTANC | 0320008414 | IL | OTHER |
DEA LICENSE NUMBER | FU0466385 | IN | OTHER |