Provider Demographics
NPI:1003864810
Name:CENTRAL DUPAGE HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:CENTRAL DUPAGE HOSPITAL ASSOCIATION
Other - Org Name:NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-933-5501
Mailing Address - Street 1:25 NORTH WINFIELD RD.
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-933-1600
Mailing Address - Fax:
Practice Address - Street 1:25 NORTH WINFIELD RD.
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-933-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5030138OtherUHC PROVIDER ID NUMBER
IL0363OtherBLUE CROSS PROVIDER ID#
IL=========001Medicaid
IL0363OtherBLUE CROSS PROVIDER ID#
IL=========401Medicaid
IL820800Medicare PIN