Healthcare Provider Details

I. General information

NPI: 1427146430
Provider Name (Legal Business Name): LA RABIDA CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 SOUTH PROMONTORY DRIVE
CHICAGO IL
60649
US

IV. Provider business mailing address

6501 SOUTH PROMONTORY DRIVE
CHICAGO IL
60649
US

V. Phone/Fax

Practice location:
  • Phone: 773-363-6700
  • Fax: 773-363-6774
Mailing address:
  • Phone: 773-363-6700
  • Fax: 773-363-6774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number0003012
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number StateIL

VIII. Authorized Official

Name: ROLLA SWEIS
Title or Position: PRESIDENT & CEO
Credential: PHARMD, MA
Phone: 773-753-8631