Organization · Type 2 NPI

Loyola University Medical Center

Community/Retail Pharmacy · Maywood, IL

NPI number 1104462126 Active

Practice location

2160 S 1st Ave Rm 150-1610
Maywood, IL 60153-3328

Call (708) 216-3743 Map

Mailing address

2160 S 1st Ave
Maywood, IL 60153-3328

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1104462126
Entity type: Organization (Type 2)
Issued: Nov 25, 2019
Last updated: Nov 25, 2019
Status: Active
Subpart: Yes of Loyola University Medical Center

Other names

Loyola Outpatient Center · doing business as

Authorized official

Adenrele Adekunbi Kolawole
Director Billing Operations
(708) 216-3743

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104462126

Loyola University Medical Center's National Provider Identifier is 1104462126, issued on Nov 25, 2019. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Maywood, IL. The record was last updated on Nov 25, 2019.