Healthcare Provider Details

I. General information

NPI: 1861432932
Provider Name (Legal Business Name): NORTHWEST COMMUNITY PHYSICIANS ASSOCIATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W. CENTRAL ROAD NORTHWEST COMMUNITY HOSPITAL
ARLINGTON HEIGHTS IL
60005
US

IV. Provider business mailing address

520 E 22ND ST
LOMBARD IL
60148-6110
US

V. Phone/Fax

Practice location:
  • Phone: 874-618-1000
  • Fax:
Mailing address:
  • Phone: 630-874-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ZENN
Title or Position: CEO
Credential:
Phone: 847-618-1000