Healthcare Provider Details

I. General information

NPI: 1932141645
Provider Name (Legal Business Name): ELMHURST MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E BRUSH HILL RD
ELMHURST IL
60126-5658
US

IV. Provider business mailing address

155 E BRUSH HILL RD
ELMHURST IL
60126-5658
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-0423
  • Fax: 331-221-3705
Mailing address:
  • Phone: 331-221-4890
  • Fax: 331-221-3705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number0059002818
License Number StateIL

VIII. Authorized Official

Name: RICHARD HRABSKI
Title or Position: PHARMACY DIRECTOR
Credential: PHARM D
Phone: 331-221-0423