NPIMap

Organization Active NPI

Loyola University Medical Center

Doing business as Foster G. McGaw Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Maywood, IL
National Provider Identifier
1063504165
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
0005801 Issued in IL
Legal business name
LOYOLA UNIVERSITY MEDICAL CENTER
Doing business as
Foster G. McGaw Hospital
Practice address
2160 S First Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
Fax
(708) 216-0593
NPI assigned
Sep 28, 2006
Last updated
Jun 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melissa M Lukasick
Title
Chief Financial Officer
Phone
(708) 216-5723

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Dialysis Technician 2472R0900X 0004630 IL
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 0005801 IL Primary
General Acute Care Hospital 282N00000X 0005801 IL

Addresses

Primary practice location

2160 S First Ave
Maywood, IL 60153-3328

Mailing address

2160 S First Ave
Maywood, IL 60153-3328
Phone (708) 216-3510

Other identifiers 4

IdentifierTypeStateIssuer
500OtherILBLUE CROSS
1671580OtherILBC FEDERAL HOME HEALTH
0564080001OtherILMEDICARE HOME INFUSION
9729OtherILBLUE CROSS HOME INFUSION

Other names 1

  • Foster G. McGaw Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080123000439 IL Part A Provider - End-Stage Renal Disease Facility (ESRD) 3779488903 Practice locations: Maywood, IL

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Loyola University Medic15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
RML Specialty HospitalHinsdale, IL, CCN 142010 Hospital Limited Partnership Interest (49.5%) Aug 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1063504165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3510",
            "fax_number": "708-216-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000",
            "fax_number": "708-216-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYOLA UNIVERSITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "LUKASICK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "708-216-5723"
    },
    "taxonomies": [
        {
            "code": "2472R0900X",
            "taxonomy_group": "",
            "desc": "Technician, Other, Renal Dialysis",
            "state": "IL",
            "license": "0004630",
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "IL",
            "license": "0005801",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0005801",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "500",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC FEDERAL HOME HEALTH",
            "identifier": "1671580",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HOME INFUSION",
            "identifier": "0564080001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS HOME INFUSION",
            "identifier": "9729",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Foster G. McGaw Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.