Healthcare Provider Details

I. General information

NPI: 1669802526
Provider Name (Legal Business Name): NORTHWEST COMMUNITY HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21481 N RAND RD
KILDEER IL
60047-3061
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 847-618-9696
  • Fax:
Mailing address:
  • Phone: 847-618-3481
  • Fax: 847-618-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL C HARTKE
Title or Position: COO
Credential:
Phone: 847-618-5004