Basic Information
| Provider Information | |||||||||
| NPI: | 1467830745 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCGAW MEDICAL CENTER OF NU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 950 W BELLE PLAINE AVE | ||||||||
| Address2: | APT 1E | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606132488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128236642 | ||||||||
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| Practice Location | |||||||||
| Address1: | 737 N MICHIGAN AVE, STE 1600 NMH | ||||||||
| Address2: | CARDIOVASCULAR IMAGING | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129265200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2015 | ||||||||
| LastUpdateDate: | 05/07/2015 | ||||||||
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| AuthorizedOfficialLastName: | CARR | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROFESSOR OF CARDIOVASCULAR IMAGING | ||||||||
| AuthorizedOfficialTelephone: | 3129265200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 125065949 | IL | Y | Hospitals | General Acute Care Hospital |
No ID Information.