Loyola University School of Nursing - School-Based Health Center

NPI #1558690628 in Maywood, Illinois

Provider Information

NPI Number: 1558690628
Entity Type: Organization
Organization Name: Loyola University School of Nursing - School-Based Health Center
Subpart: Yes (part of a larger organization)
Parent Organization: LOYOLA UNIVERSITY HEALTH SYSTEM
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Dec 18, 2009
Last Updated: Dec 18, 2009

Practice Location

Address: 807 SOUTH FIRST AVENUE
Address 2: SCHOOL-BASED HEALTH CENTER AT PROVISO EAST HIGH SCHOOL
City: Maywood
State: Illinois
ZIP Code: 60153
Phone: (708) 449-9522

Authorized Official

Name: DR. DIANA P. HACKBARTH, PHD, RN, FAAN
Title: PROJECT DIRECTOR: LOYOLA UNIVERSITY
Phone: (708) 216-3670

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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