LORETTO HOSPITAL (NPI# 1306318753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306318753 |
| Entity Type | Organization |
| Organization Name | LORETTO HOSPITAL |
| Other Organization Name | LORETTO HOSPITAL PHYSICIAN GROUP |
| Practice Address |
645 S Central Ave Chicago IL 60644-5059 |
| Practice Telephone | 7738545430 |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2019-01-02 |
| Authorized Official Name | CATHY WILLIAMS (DIRECTOR OF BUSINESS OFFICE) |
| Authorized Official Telephone | 7738545066 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 282N00000X | General Acute Care Hospital | Hospitals | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Loretto Hospital Physician Group | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Madison St, Oak Park, IL 603024405 | 7086601800 | |
| 6905 Cermak Rd Ste A, Berwyn, IL 604022175 | 7087490091 | |
| 5130 W Jackson Blvd, Chicago, IL 606444332 | 7738545072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326516584 | Loretto Hospital | Clinic/Center | 7431 S East End Ave, Floor 1st Suite 2, Chicago, IL 60649-3611 | 2018-11-06 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1376025304 | Loretto Hospital | Clinic/Center | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2018-09-06 |
| 1073092359 | Loretto Hospital | Clinic/Center | 6905 Cermak Rd Ste A, Berwyn, IL 60402-2175 | 2018-08-08 |
| 1801314380 | Loretto Hospital | Clinic/Center | 645 S Central Ave, Chicago, IL 60644-5059 | 2017-09-05 |
| 1801336193 | Loretto Hospital | Substance Abuse Rehabilitation Facility | 645 S Central Ave, Chicago, IL 60644-5059 | 2017-03-06 |
| 1215395496 | Loretto Hospital | Substance Abuse Rehabilitation Facility | 645 S Central Ave, Chicago, IL 60644-5059 | 2016-02-03 |
| 1023342664 | Loretto Hospital | Clinic/Center | 645 S Central Ave, Chicago, IL 60644-5059 | 2009-09-30 |
| 1831364132 | Loretto Hospital | Clinic/Center | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2008-04-28 |
| 1447280284 | Loretto Hospital | General Acute Care Hospital | 645 S Central Ave, Chicago, IL 60644-5059 | 2006-07-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LORETTO HOSPITAL | 645 S Central Ave, Chicago, IL 60644-5059 |
| Street Address |
645 S CENTRAL AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60644-5059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174512917 | M S Bhagavan | Internal Medicine | 645 S Central Ave, Chicago, IL 60644 | 2005-10-14 |
| 1811514532 | Meridian Physician Group Pllc | Podiatrist | 645 S Central Ave, Chicago, IL 60644-5059 | 2020-06-29 |
| 1104440361 | Saarah Alkhairy | Psychiatry & Neurology | 645 S Central Ave, Chicago, IL 60644-5059 | 2020-06-03 |
| 1821612185 | Islam Khaled Hussein | Psychiatry & Neurology | 645 S Central Ave, Chicago, IL 60644-5059 | 2020-06-02 |
| 1417571761 | Sam K Suhail | Psychiatry & Neurology | 645 S Central Ave, Chicago, IL 60644-5059 | 2020-06-02 |
| 1841814191 | Omer Majdobeh | Psychiatry & Neurology | 645 S Central Ave, Chicago, IL 60644-5059 | 2020-06-02 |
| 1053944405 | Ferrer Hameed | Physical Therapist | 645 S Central Ave, Chicago, IL 60644-5059 | 2020-02-13 |
| 1780246488 | Onetha U Taylor | Nurse Practitioner | 645 S Central Ave, Chicago, IL 60644-5059 | 2019-07-02 |
| 1548826571 | Stephanie Atoyebi | Podiatrist | 645 S Central Ave, Chicago, IL 60644-5059 | 2019-05-15 |
| 1376039263 | Metropolitan Behavioral Associates, Inc. | Psychiatry & Neurology | 645 S Central Ave, Chicago, IL 60644 | 2018-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535638 | Marta Yvonne Palmer | Technician | 5008 W Adams, Chicago, IL 60644 | 2019-09-04 |
| 1861056848 | B U I L D Incorporated | Social Worker | 5100 W Harrison St., Chicago, IL 60644 | 2019-04-25 |
| 1851806269 | Habilitative Systems, Inc. | Case Management | 4732 W Ohio St, Chicago, IL 60644 | 2017-12-07 |
| 1336408665 | Meghan Nancy Daw | Dietitian, Registered | 646 S Central Ave, Chicago, IL 60644 | 2012-05-07 |
| 1164790515 | Elizabeth Eleanor Reid-tate | Pharmacist | 5222 W. Madison Avenue, Chicago, IL 60644 | 2011-12-13 |
| 1134458466 | Power Teen Program | Psychologist | 300 N Central Ave, Chicago, IL 60644 | 2009-12-16 |
| 1417198342 | Betty Jean Lofton | Counselor | 5938 W. Midway Park, Chicago, IL 60644 | 2009-03-24 |
| 1881856094 | Sanjay M. Patel M.d. S.c. | Psychiatry & Neurology | 5730 W. Roosevelt Road, Chicago, IL 60644 | 2008-06-29 |
| 1639348691 | Ysl Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 5107-21 West Jackson Blvd, Chicago, IL 60644 | 2008-02-25 |
| 1073795845 | Maryanne Rakidzioski | Occupational Therapist | 5103 W Jackson Blvd, Chicago, IL 60644 | 2007-12-03 |
| Find all providers in zip 60644 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164067054 | League Corp. | General Practice | 515 N State St Fl 8, Chicago, IL 60654-9102 | 2019-11-14 |
| 1679129977 | Chronic Care Solutions LLC | General Practice | 3050 W Columbia Ave, Chicago, IL 60645-4006 | 2019-08-13 |
| 1952809451 | Josie M Abogast | General Practice | 3219 N. Clark St., Chicago, IL 60657 | 2018-01-30 |
| 1043759939 | Royalty Intervention Group Inc | General Practice | 10307 S Peoria St, Suite 100, Chicago, IL 60643-3007 | 2017-02-13 |
| 1215482567 | David John De Jong | General Practice | 226 W Willow St, Chicago, IL 60614-5716 | 2016-08-16 |
| 1720474885 | Healthwise Medical Clinic LLC | General Practice | 8349 S Baltimore Ave, Chicago, IL 60617-2110 | 2015-04-15 |
| 1578952321 | Joseph Lawrence Mcdevitt | General Practice | 2650 N Orchard St Apt 2f, Chicago, IL 60614-1576 | 2015-01-16 |
| 1548662851 | Healthjoy | General Practice | 208 W Huron St, Chicago, IL 60654-3913 | 2014-09-17 |
| 1629478359 | Alivio Medical Center | General Practice | 1450-1510 W. Cermak Road, Chicago, IL 60608 | 2014-08-29 |
| 1699193409 | Kenya R Thomas | General Practice | 1133 E 83rd St Unit 108, Chicago, IL 60619-6464 | 2014-03-31 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.