Available in the table to your right are the required forms for credentialing. Send completed typed State of Illinois Credentialing Application via e-mail as a word document to department credentialing liason, Angela Trejo, firstname.lastname@example.org.
All other required forms and documents can be mailed/emailed/faxed to:
Department Credentialing Liason, Angela Trejo
Department of Medicine
University of Illinois at Chicago
840 S. Wood Street (M/C 787)
Chicago Il 60612
Email Option: email@example.com
Fax Option: 312 413-5604
In addition, you must go to the Find-A-Doctor link http://hospital.uillinois.edu/Marketing/Forms/FAD.html and complete the Find-A-Doctor Request Form. The Find-A-Doctor database will help potential patients to locate a physician, learn about their background and to make an online appointment request. Please be sure to complete all required fields.
Once you have completed and gathered the required documents, please call 312-413-8687 to make an appointment to meet with your department credentialing liason. This meeting is designed to provide a courtesy review of your credentialing application and to answer questions you may have.