Provider Demographics
NPI:1225073984
Name:WEST SUBURBAN MEDICAL CENTER
Entity Type:Organization
Organization Name:WEST SUBURBAN MEDICAL CENTER
Other - Org Name:CENTER FOR CANCER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SYSTEM DIRECTOR PATIENT FINANCIAL S
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PFISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-813-3716
Mailing Address - Street 1:7411 LAKE ST
Mailing Address - Street 2:STE L140
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1888
Mailing Address - Country:US
Mailing Address - Phone:708-763-5531
Mailing Address - Fax:708-763-5550
Practice Address - Street 1:7420 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1800
Practice Address - Country:US
Practice Address - Phone:708-763-2700
Practice Address - Fax:708-763-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1620469OtherBCBS GRP
IL803900Medicare ID - Type UnspecifiedMEDICARE GROUP