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Organization

LURIE CHILDRENS SURGICAL FOUNDATION INC

Active
Other names
LCSF INC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHERYL WITHERS CPCS (DIR OF 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 # 118, CHICAGO, IL 60611-2991
(312) 227-6415
(312) 227-9409

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
207XP3100X
Pediatric Orthopaedic Surgery Physician
208200000X
Plastic Surgery Physician
2086S0120X
Pediatric Surgery Physician
Primary
2088P0231X
Pediatric Urology Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
F100287598
IL
Enumeration date
08/22/2018
Last updated
08/24/2022
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