Provider Demographics
NPI:1083733414
Name:NORTHWEST GENERAL SURGEONS LTD
Entity Type:Organization
Organization Name:NORTHWEST GENERAL SURGEONS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAHLINGHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-631-9699
Mailing Address - Street 1:7447 W TALCOTT
Mailing Address - Street 2:SUITE 427
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-631-9699
Mailing Address - Fax:773-631-4299
Practice Address - Street 1:7447 W TALCOTT
Practice Address - Street 2:SUITE 427
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-631-9699
Practice Address - Fax:773-631-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL81618523OtherBLUE SHIELD
IL920100Medicare ID - Type Unspecified