Organization
LOYOLA UNIVERSITY MEDICAL CENTER
Active
Other names
Foster G. McGaw Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA M LUKASICK (CHIEF FINANCIAL OFFICER)
(708) 216-5723
Entity
Organization
Contact information
Practice address
2160 S FIRST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
(708) 216-0593
Mailing address
2160 S FIRST AVE, MAYWOOD, IL 60153-3328
(708) 216-3510
(708) 216-0593
Taxonomy
Speciality
Code
Description
License number
State
2472R0900X
Renal Dialysis Technician
0004630
IL
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0005801
IL
282N00000X
General Acute Care Hospital
0005801
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0564080001
MEDICARE HOME INFUSION
IL
01
—
1671580
BC FEDERAL HOME HEALTH
IL
01
—
500
BLUE CROSS
IL
01
—
9729
BLUE CROSS HOME INFUSION
IL
Enumeration date
09/28/2006
Last updated
06/16/2025
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