Provider Demographics
NPI:1780734103
Name:THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Entity type:Organization
Organization Name:THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF AMBULATORY RX
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCARPELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-834-5601
Mailing Address - Street 1:5758 S MARYLAND AVE # MC0010
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1426
Mailing Address - Country:US
Mailing Address - Phone:773-834-7002
Mailing Address - Fax:773-834-7005
Practice Address - Street 1:5758 S MARYLAND AVE # MC0010
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1426
Practice Address - Country:US
Practice Address - Phone:773-834-7002
Practice Address - Fax:773-834-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054017383333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy