Organization
LURIE CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
LCMG
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL WITHERS CPCS (DIR 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, BOX 118, CHICAGO, IL 60611-2991
(312) 227-6412
(312) 227-9409
Taxonomy
Speciality
Code
Description
License number
State
207ZP0213X
Pediatric Pathology Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
Other
Enumeration date
05/17/2006
Last updated
08/24/2022
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