LOYOLA UNIVERSITY MEDICAL CENTER NPI 1063504165

NPI Information

NPI: 1063504165
Provider Name: LOYOLA UNIVERSITY MEDICAL CENTER

Doing Business As: FOSTER G. MCGAW HOSPITAL

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2160 S FIRST AVE
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-3510
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LOYOLA UNIVERSITY MEDICAL CENTER is an end-stage renal disease (esrd) treatment clinic center in Maywood, IL. LOYOLA UNIVERSITY MEDICAL CENTER NPI is 1063504165. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Foster G. Mcgaw Hospital.

The provider's business location address is:

2160 S FIRST AVE
MAYWOOD, IL
ZIP 60153-328
Phone: (708) 216-3510
Fax: (708) 216-0593

The provider's authorized official is Larry M Goldberg .
The authorized official title is Ceo and has the following contact phone number (708) 216-3215.

The enumeration date for this NPI number is 9/28/2006 and was last updated on 4/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2472R0900X	Technician, Other	Renal Dialysis	0004630	ILLINOIS	No
2	282N00000X	General Acute Care Hospital		0005801	ILLINOIS	No
3	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	0005801	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0564080001	OTHER	ILLINOIS	MEDICARE HOME INFUSION
2	142329	MEDICARE OSCAR/CERTIFICATION	ILLINOIS
3	9729	OTHER	ILLINOIS	BLUE CROSS HOME INFUSION
4	1671580	OTHER	ILLINOIS	BC FEDERAL HOME HEALTH
5	500	OTHER	ILLINOIS	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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