Healthcare Provider Details

I. General information

NPI: 1477420412
Provider Name (Legal Business Name): ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 ARBOR GLEN BLVD FL 3
SCHAUMBURG IL
60195-3114
US

IV. Provider business mailing address

1895 ARBOR GLEN BLVD FL 3
SCHAUMBURG IL
60195-3114
US

V. Phone/Fax

Practice location:
  • Phone: 872-323-5080
  • Fax: 312-204-5900
Mailing address:
  • Phone: 872-323-5080
  • Fax: 312-204-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALEX P MILLER
Title or Position: SVP, CFO & TREASURER
Credential:
Phone: 312-227-1520