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General NPI Number Information
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NPI Number | 1851541049
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Entity Type | Organization
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Legal Business Name | NORTHWESTERN MCGAW MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 4938 S DREXEL BLVD APT 212
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City | CHICAGO
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State | IL
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Zip | 60615-2700
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Country | US
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Telephone | 312-450-4883
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Fax |
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Provider Business Mailing Address
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Address Line | 4938 S DREXEL BLVD APT 212
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City | CHICAGO
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State | IL
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Zip | 60615-2700
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Country | US
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Telephone | 312-450-4883
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Fax |
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Authorized Official
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Title or Position | UROLOGY RESIDENT
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Name | DR. AISHA KHALALI TAYLOR
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Credential | M.D.
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Telephone | 312-450-4883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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