Healthcare Provider Details

I. General information

NPI: 1235234535
Provider Name (Legal Business Name): ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE # 44
CHICAGO IL
60611
US

IV. Provider business mailing address

225 E CHICAGO AVE #44
CHICAGO IL
60611-2991
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-7118
  • Fax: 312-227-9505
Mailing address:
  • Phone: 312-227-7118
  • Fax: 312-227-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number0005843
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0005843
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number0005843
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number0005843
License Number StateIL

VIII. Authorized Official

Name: ALEX P MILLER
Title or Position: SVP AND CHIEF FINANCIAL OFFICER
Credential:
Phone: 312-227-1520