Healthcare Provider Details

I. General information

NPI: 1710490909
Provider Name (Legal Business Name): NORTHWEST COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL ROAD SUITE 1100
ARLINGTON HEIGHTS IL
60010-2349
US

IV. Provider business mailing address

800 W CENTRAL ROAD
ARLINGTON HEIGHTS IL
60010-2349
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-7427
  • Fax: 847-618-7429
Mailing address:
  • Phone: 847-618-7427
  • Fax: 847-618-7429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054.020483
License Number State

VIII. Authorized Official

Name: STEPHEN O SCOGNA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 847-618-5000