MEDICARE: NORTHWEST COMMUNITY HOSPITAL

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	282N00000X	General Acute Care Hospital	0001701	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	334	OTHER	IL	BLUE CROSS

General Provider Information

NPI Number	:	1578932869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	1410 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4822
Country	:	US
Telephone Number	:	847-221-4200
Fax Number	:	847-221-4296

Provider Business Practice Location Address
First Line	:	1410 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4822
Country	:	US
Telephone Number	:	847-221-4200
Fax Number	:	847-221-4296

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN O SCOGNA
Credential	:
Telephone Number	:	847-618-5000

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	12/03/2015

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Directions to “NORTHWEST COMMUNITY HOSPITAL ” Practice Location

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