Provider Demographics
NPI:1003396110
Name:NORTHWESTERN MEMORIAL HEALTHCARE
Entity Type:Organization
Organization Name:NORTHWESTERN MEMORIAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR. REVENUE CYCLE
Authorized Official - Prefix:MS
Authorized Official - First Name:VERNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-926-4843
Mailing Address - Street 1:541 N FAIRBANKS CT FL 25
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3319
Mailing Address - Country:US
Mailing Address - Phone:312-926-4843
Mailing Address - Fax:312-694-0430
Practice Address - Street 1:171 N ABERDEEN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1669
Practice Address - Country:US
Practice Address - Phone:312-926-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy