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General NPI Number Information
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NPI Number | 1023296357
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Entity Type | Organization
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Legal Business Name | LOYOLA UNIVERSITY MEDICAL CENTER
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-5059
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-5059
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Fax |
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Authorized Official
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Title or Position | RESIDENCY PROGRAM DIRECTOR
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Name | DR. DAVID SCHILLING
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Credential | M.D.
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Telephone | 708-216-5059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State | IL
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