# LOYOLA UNIVERSITY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOYOLA UNIVERSITY MEDICAL CENTER
- **Other names:** Loyola Outpatient Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164200275
- **Legal business name:** LOYOLA UNIVERSITY MEDICAL CENTER
- **Authorized official:** SHAWN VINCENT (CEO)
- **Authorized official phone:** (708) 216-3215

## Contact information

- **Practice address:** 2160 S. 1ST AVENUE, BLDG 150 ROOM 1600, MAYWOOD, IL 60153
- **Practice address phone:** (708) 717-5320
- **Mailing address:** 2160 S. 1ST AVENUE, BLDG 150 ROOM 1600, MAYWOOD, IL 60153
- **Mailing address phone:** (708) 717-5320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336S0011X | Specialty Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/19/2023
- **Last updated:** 09/19/2023