MEDICARE: NORTHWEST NEUROLOGY, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician		IL

General Provider Information

NPI Number	:	1821215187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST NEUROLOGY, LTD

Provider Business Mailing Address
First Line	:	2260 W HIGGINS RD
Second Line	:	STE 201
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60195-2431
Country	:	US
Telephone Number	:	847-882-6604
Fax Number	:	847-882-6228

Provider Business Practice Location Address
First Line	:	1732 W ALGONQUIN RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3405
Country	:	US
Telephone Number	:	847-882-6604
Fax Number	:	847-882-6228

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	CATHY SACOMANO
Credential	:
Telephone Number	:	847-882-6604

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/22/2020

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