Organization
LOYOLA UNIVERSITY MEDICAL CENTER
Active
Parent organization
LOYOLA UNIVERSITY MEDICAL CENTER
Other names
Loyola Outpatient Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOYOLA UNIVERSITY MEDICAL CENTER
Authorized official
ADENRELE ADEKUNBI KOLAWOLE (DIRECTOR BILLING OPERATIONS)
(708) 216-3743
Entity
Organization
Contact information
Practice address
2160 S 1ST AVE RM 150-1610, MAYWOOD, IL 60153-3328
(708) 216-3743
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-3743
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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