Organization
LOYOLA UNIVERSITY MEDICAL CENTER
Active
Parent organization
LOYOLA UNIVERSITY MEDICAL CENTER
Other names
Loyola University Medical Ctr Optical Shop at Burr Ridge
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOYOLA UNIVERSITY MEDICAL CENTER
Authorized official
MR. AJAY S. SIAL (CFO)
(708) 216-4252
Entity
Organization
Contact information
Practice address
6800 N FRONTAGE RD, BURR RIDGE, IL 60527-7819
(708) 327-1004
(708) 327-1003
Mailing address
2160 S. FIRST AVENUE, MAYWOOD, IL 60153-3304
(708) 216-8686
(708) 216-8059
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
04/29/2014
Last updated
07/02/2014
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