| Organization Name: | LOYOLA UNIVERSITY MEDICAL CENTER |
| NPI Number: | 1255483962 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN P. MORDACH (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 9608 S Roberts Rd Hickory Hills |
| State: | IL US |
| Postal Code: | 604572238 |
| Phone Number: | 7082163510 |
| Fax Number: | |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 03/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251F00000X |
| License Number: | 0004630 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Home Infusion |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |