Healthcare Provider Details
I. General information
NPI: 1346235314
Provider Name (Legal Business Name): NORTHWESTERN MEDICAL FACULTY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2005
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
DEPT 5777
CAROL STREAM IL
60122
US
IV. Provider business mailing address
DEPT 5777
CAROL STREAM IL
60122
US
V. Phone/Fax
- Phone: 312-926-3030
- Fax: 312-694-0090
- Phone: 312-926-3030
- Fax: 312-694-0090
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SABINA
STRZEMINSKA
Title or Position: DIRECTOR
Credential:
Phone: 312-695-0646