Healthcare Provider Details

I. General information

NPI: 1326969783
Provider Name (Legal Business Name): LA RABIDA CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 W 143RD ST STE 280
HOMER GLEN IL
60491-7715
US

IV. Provider business mailing address

6501 S PROMONTORY DR
CHICAGO IL
60649-1002
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 TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

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