Provider Demographics
NPI:1720191653
Name:UNIVERSITY OF CHICAGO
Entity Type:Organization
Organization Name:UNIVERSITY OF CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE PROFESSOR OF MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GAJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:773-702-4601
Mailing Address - Street 1:5841 S MARYLAND AVE # 2115
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1447
Mailing Address - Country:US
Mailing Address - Phone:773-702-4601
Mailing Address - Fax:773-834-0188
Practice Address - Street 1:5841 S MARYLAND AVE # 2115
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-4601
Practice Address - Fax:773-834-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL652280Medicare UPIN