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NPI Code Detail

MEDICARE: LARABIDA CHILDRENS HOSPITAL

MEDICARE: LARABIDA CHILDRENS HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1281PC2000XChildren's Chronic Disease Hospital0003012IL

General Provider Information

NPI Number : 1518055524
Entity Type Code : Organization
Provider Name (Legal Business Name) : LARABIDA CHILDRENS HOSPITAL
Provider Business Mailing Address
First Line : 6501 S PROMONTORY DR
Second Line :
City : CHICAGO
State : IL
Zip : 60649-1003
Country : US
Telephone Number : 773-363-6700
Fax Number : 773-363-6315
Provider Business Practice Location Address
First Line : 6501 S PROMONTORY DR
Second Line :
City : CHICAGO
State : IL
Zip : 60649-1003
Country : US
Telephone Number : 773-363-6700
Fax Number : 773-363-6315
Authorized Official
Title or Position : PRESIDENT & CEO
Name : ROLLA SWEIS
Credential : PHARMD, MA
Telephone Number : 773-753-8631
Provider Enumeration Date : 10/11/2006
Last Update Date : 10/02/2024

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Directions to “LARABIDA CHILDRENS HOSPITAL ” Practice Location

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