Healthcare Provider Details

I. General information

NPI: 1619270089
Provider Name (Legal Business Name): NORTHWEST COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-6572
  • Fax:
Mailing address:
  • Phone: 847-618-6572
  • Fax: 847-618-6569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number041.211595
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number209.004411
License Number StateIL

VIII. Authorized Official

Name: MR. KEITH AMMONS
Title or Position: DIRECTOR CANCER SERVICES
Credential: MS, RTT
Phone: 847-618-6570