Healthcare Provider Details
I. General information
NPI: 1164744009
Provider Name (Legal Business Name): MIDWESTERN UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2010
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5855 W UTOPIA RD
GLENDALE AZ
85308-5251
US
IV. Provider business mailing address
26520 NETWORK PL
CHICAGO IL
60673-1265
US
V. Phone/Fax
- Phone: 623-537-6000
- Fax: 623-806-7689
- Phone: 630-743-4500
- Fax: 623-806-7689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QS0112X |
| Taxonomy | Oral and Maxillofacial Surgery Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
J
SWEENEY
Title or Position: VP & CFO
Credential:
Phone: 630-515-7307