Basic Information
| Provider Information | |||||||||
| NPI: | 1497018154 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANN AND ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 E CHICAGO AVE | ||||||||
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| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112605 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 225 E CHICAGO AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3122274000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2012 | ||||||||
| LastUpdateDate: | 06/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | DEAL | ||||||||
| AuthorizedOfficialFirstName: | BARBABA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIVISION CHIEF OF CARDIOLOGY | ||||||||
| AuthorizedOfficialTelephone: | 3122274000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 281PC2000X | 209008846 | IL | Y | Hospitals | Chronic Disease Hospital | Children |
No ID Information.