Provider Demographics
NPI:1568815421
Name:UIC ASSISTIVE TECHNOLOGY UNIT
Entity Type:Organization
Organization Name:UIC ASSISTIVE TECHNOLOGY UNIT
Other - Org Name:ATU
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-413-7784
Mailing Address - Street 1:1640 W ROOSEVELT RD
Mailing Address - Street 2:415
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1316
Mailing Address - Country:US
Mailing Address - Phone:312-413-2110
Mailing Address - Fax:312-413-3709
Practice Address - Street 1:1640 W ROOSEVELT RD
Practice Address - Street 2:415
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1316
Practice Address - Country:US
Practice Address - Phone:312-413-2110
Practice Address - Fax:312-413-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty