Provider Demographics
NPI:1376025304
Name:LORETTO HOSPITAL
Entity Type:Organization
Organization Name:LORETTO HOSPITAL
Other - Org Name:LORETTO HOSPITAL AT SYMPHONY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-854-5066
Mailing Address - Street 1:645 S CENTRAL AVE
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60644
Mailing Address - Country:US
Mailing Address - Phone:773-854-5066
Mailing Address - Fax:773-626-7902
Practice Address - Street 1:5130 W JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-4332
Practice Address - Country:US
Practice Address - Phone:773-626-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center