Healthcare Provider Details

I. General information

NPI: 1477937373
Provider Name (Legal Business Name): EDWARD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SPALDING DR SUITE 101
NAPERVILLE IL
60540-6550
US

IV. Provider business mailing address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-5204
  • Fax: 630-527-5244
Mailing address:
  • Phone: 630-527-5204
  • Fax: 630-527-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054019385
License Number StateIL

VIII. Authorized Official

Name: MR. BLAKE R LANCASTER
Title or Position: PHARMACY MANAGER
Credential:
Phone: 205-795-8800