Loyola University Physician Foundation

NPI #1235148891 in Maywood, Illinois

Provider Information

NPI Number: 1235148891
Entity Type: Organization
Organization Name: Loyola University Physician Foundation
Primary Specialty: General Practice
Enumeration Date: Aug 5, 2006
Last Updated: Sep 2, 2008

Practice Location

Address: 2160 S 1ST AVE
City: Maywood
State: Illinois
ZIP Code: 60153-3328
Phone: (800) 424-6307

Authorized Official

Name: MR. PETER GOUWS
Title: VICE PRESIDENT AND CFO
Phone: (708) 216-3981

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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