Provider Demographics
NPI:1780839746
Name:UNIVERSITY OF CHICAGO
Entity Type:Organization
Organization Name:UNIVERSITY OF CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-702-2123
Mailing Address - Street 1:5841 SOUTH MARYLAND
Mailing Address - Street 2:MC 3026
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637
Mailing Address - Country:US
Mailing Address - Phone:773-702-2123
Mailing Address - Fax:
Practice Address - Street 1:5841 SOUTH MARYLAND
Practice Address - Street 2:MC 3026
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-702-2123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125054984261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service