Healthcare Provider Details

I. General information

NPI: 1538279518
Provider Name (Legal Business Name): ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 312-573-4581
  • Fax: 312-573-4500
Mailing address:
  • Phone: 312-573-4581
  • Fax: 312-573-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number0003137
License Number StateIL

VIII. Authorized Official

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