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Organization

LOYOLA UNIVERSITY MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY M GOLDBERG (CEO)
(708) 216-3215
Entity
Organization

Contact information

Practice address
2160 S 1ST AVE, OUTPATIENT CENTER ROOM 1620, MAYWOOD, IL 60153-3328
(708) 216-9000
(708) 216-8059
Mailing address
2160 S 1ST AVE, OUTPATIENT CENTER ROOM 1620, MAYWOOD, IL 60153-3328
(708) 216-9000
(708) 216-8059

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
12/18/2012
Last updated
07/06/2015
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