OrganizationActive
Loyola University Medical Center
NPI 1104462126 · Community/Retail Pharmacy · Maywood, IL
Provider details
- NPI number
- 1104462126
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Parent organization
- Loyola University Medical Center
- Organization subpart
- Yes
- Authorized official
- Adenrele Kolawole, Director Billing Operations(708) 216-3743
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2160 S 1st Ave Rm 150-1610
Maywood, IL 60153-3328
Phone: (708) 216-3743
Street-level locationGet directions
Mailing address
2160 S 1st Ave
Maywood, IL 60153-3328
Other names (DBA / former)
- Doing business as
- Loyola Outpatient Center
Registry dates
- Enumerated
- 2019-11-25
- Last updated
- 2019-11-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.