BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
840 S Wood St Room 163 Mc 884
Chicago, IL 60612
312-996-6887
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | IL | 054.017116 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
STATE LICENSE NUMBER | 054017116 | IL | OTHER |
DEA LICENSE NUMBER | BU1754856 | IL | OTHER |
NCPDP NUMBER | 1453428 | IL | OTHER |
STATE CONTROLLED SUBSTANC | 032-005923 | IL | OTHER |