Healthcare Provider Details

I. General information

NPI: 1831472380
Provider Name (Legal Business Name): ADVOCATE HOPE CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10515 LEXINGTON LN.
FRANKFORT IL
60423-2209
US

IV. Provider business mailing address

10515 LEXINGTON LN
FRANKFORT IL
60423-2209
US

V. Phone/Fax

Practice location:
  • Phone: 815-719-0366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number125059213
License Number StateIL

VIII. Authorized Official

Name: LAURIE MARIE SLAVIN
Title or Position: REGISTERED DIETICIAN
Credential: M.S.
Phone: 708-684-5753