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General NPI Number Information
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NPI Number | 1649499096
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Entity Type | Organization
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Legal Business Name | WEST SUBURBAN MEDICAL CENTER
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 52256 EAGLE WAY W SUBURBAN HEALTH CARE PHYSICIANS SVCS
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City | CHICAGO
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State | IL
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Zip | 60678-1522
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Country | US
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Telephone | 708-763-7877
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Fax | 708-763-5550
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Provider Business Mailing Address
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Address Line | 7411 LAKE ST SUITE L140
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City | RIVER FOREST
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State | IL
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Zip | 60305-1876
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Country | US
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Telephone | 708-763-7877
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Fax | 708-763-5550
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Authorized Official
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Title or Position | SYSTEM DIRECTOR PATIENT FINANCIAL S
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Name | SUSAN PFISTER
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Credential |
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Telephone | 847-813-3716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IL
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