MEDICARE: MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVERSITY

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	261QM1300X	Multi-Specialty Clinic/Center	125059248	IL
2	2865M2000X	Military General Acute Care Hospital	125059248	IL
3	282N00000X	General Acute Care Hospital	125059248	IL

General Provider Information

NPI Number	:	1861787939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVERSITY

Provider Business Mailing Address
First Line	:	251 E HURON ST
Second Line	:	GALTER 3-150
City	:	CHICAGO
State	:	IL
Zip	:	60611-2908
Country	:	US
Telephone Number	:	312-926-2253
Fax Number	:	312-926-6905

Provider Business Practice Location Address
First Line	:	251 E HURON ST
Second Line	:	GALTER 3-150
City	:	CHICAGO
State	:	IL
Zip	:	60611-2908
Country	:	US
Telephone Number	:	312-926-2253
Fax Number	:	312-926-6905

Authorized Official
Title or Position	:	ADMINISTRATIVE MANAGER
Name	:	MS. MAIJA CERS HASIBA
Credential	:
Telephone Number	:	312-926-2253

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	06/16/2011

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Directions to “MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVERSITY ” Practice Location

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