Healthcare Provider Details

I. General information

NPI: 1467057513
Provider Name (Legal Business Name): NORTHWEST COMMUNITY HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD STE 6200
ARLINGTON HEIGHTS IL
60005-2378
US

IV. Provider business mailing address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0730
  • Fax: 847-618-0799
Mailing address:
  • Phone: 847-618-3481
  • Fax: 847-618-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HARTKE
Title or Position: CHIEF
Credential:
Phone: 847-618-5004