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Organization
LURIE CHILDREN'S MEDICAL GROUP, LLC
Active
Organization
LURIE CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
LCMG
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL WITHERS CPCS (DIR CREDENTIALING & ENROLLMENT)
(312) 227-6415
Entity
Organization
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(800) 543-7362
Mailing address
225 E CHICAGO AVE, BOX 118, CHICAGO, IL 60611-2991
(312) 227-6412
(312) 227-9409
Taxonomy
Speciality
Code
Description
License number
State
207ZP0213X
Pediatric Pathology Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
Other
Enumeration date
05/17/2006
Last updated
08/24/2022
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