Basic Information
| Provider Information | |||||||||
| NPI: | 1457318701 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHWEST COMMUNITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 W CENTRAL RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600052349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476181000 | ||||||||
| FaxNumber: | 8476185009 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 W KIRCHHOFF RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600052361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476184070 | ||||||||
| FaxNumber: | 8476184102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2006 | ||||||||
| LastUpdateDate: | 06/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | SCOGNA | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8476185018 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NORTHWEST COMMUNITY HOSPITAL | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 0001701 | IL | Y | Hospital Units | Psychiatric Unit |
ID Information
| ID | Type | State | Issuer | Description | 334 | 01 | IL | BLUE CROSS | OTHER | 6251175 | 01 | IL | AETNA | OTHER |