Healthcare Provider Details
I. General information
NPI: 1508533266
Provider Name (Legal Business Name): NORTHWEST CHICAGO URGENT CARE SC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2021
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6841 DEMPSTER ST
MORTON GROVE IL
60053-2628
US
IV. Provider business mailing address
PO BOX 10417
HOLYOKE MA
01041-2017
US
V. Phone/Fax
- Phone: 224-233-0299
- Fax: 224-233-0288
- Phone: 630-908-5500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANJAY
PATEL
Title or Position: OWNER
Credential:
Phone: 224-233-0299