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General NPI Number Information
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NPI Number | 1629346044
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Entity Type | Organization
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Legal Business Name | LURIE CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE BOX 10
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City | CHICAGO
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State | IL
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Zip | 60611-2605
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Country | US
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Telephone | 312-227-0352
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Fax | 312-227-9772
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Provider Business Mailing Address
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Address Line | 225 E CHICAGO AVE BOX 10
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City | CHICAGO
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State | IL
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Zip | 60611-2605
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Country | US
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Telephone | 312-227-0352
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Fax | 312-227-9772
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Authorized Official
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Title or Position | SENIOR SOCIAL WORKER
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Name | MS. LINA TRAN
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Credential | MSW, LCSW
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Telephone | 312-227-0352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 149.014775
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 149.014775
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 149.014775
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License Number State | IL
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