| NPI | 1255761961 |
|---|---|
| Doing Business As | UNIVERSITY CLINIC AT BLACKHAWK |
| Entity Type | Organization |
| Authorized Contact | UMA SRIRAM Director Of Fiscal Affairs 815-395-5637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2016-04-27 |