MEDICARE: NORTHWEST MEDICAL FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		IL

General Provider Information

NPI Number	:	1255510533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST MEDICAL FOUNDATION INC

Provider Business Mailing Address
First Line	:	2743 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3927
Country	:	US
Telephone Number	:	773-561-8200
Fax Number	:	773-561-8222

Provider Business Practice Location Address
First Line	:	2743 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3927
Country	:	US
Telephone Number	:	773-561-8200
Fax Number	:	773-561-8222

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH B ATTO
Credential	:	M.D.
Telephone Number	:	773-561-8200

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	11/02/2007

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