Provider Demographics
NPI:1033272273
Name:LA RABIDA CHILDREN'S HOSPITAL
Entity Type:Organization
Organization Name:LA RABIDA CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO & VP OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:RENFREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-753-8630
Mailing Address - Street 1:1111 E. 87TH STREET
Mailing Address - Street 2:SUITE 800
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-7011
Mailing Address - Country:US
Mailing Address - Phone:773-374-3748
Mailing Address - Fax:773-374-6223
Practice Address - Street 1:1111 E. 87TH STREET
Practice Address - Street 2:SUITE 800
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-7011
Practice Address - Country:US
Practice Address - Phone:773-374-3748
Practice Address - Fax:773-374-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281PC2000XHospitalsChronic Disease HospitalChildren