Healthcare Provider Details

I. General information

NPI: 1902727027
Provider Name (Legal Business Name): LA RABIDA CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 S PROMONTORY DR
CHICAGO IL
60649-1003
US

IV. Provider business mailing address

6501 S PROMONTORY DR
CHICAGO IL
60649-1003
US

V. Phone/Fax

Practice location:
  • Phone: 773-256-5925
  • Fax: 773-363-6774
Mailing address:
  • Phone: 773-256-5925
  • Fax: 773-363-6774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY MICHAEL MCWHORTER
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 773-256-5925