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General NPI Number Information
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NPI Number | 1760793921
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Entity Type | Organization
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Legal Business Name | NORTHWESTERN MCGAW FAMILY MEDICINE RESIDENCY
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2750 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5247
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Country | US
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Telephone | 312-432-4556
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5247
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Country | US
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Telephone | 312-432-4556
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | ADIANEZ ALBELO
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Credential | MD
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Telephone | 401-749-1353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | IL
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