Organization
LOYOLA UNIVERSITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN VINCENT (PRESIDENT & CEO)
(708) 216-3215
Entity
Organization
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-3215
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
IL
261QU0200X
Urgent Care Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
08/08/2006
Last updated
06/16/2025
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