Provider Demographics
NPI:1235475708
Name:WESTLAKE EMERGENCY ROOM PROVIDERS, SC
Entity Type:Organization
Organization Name:WESTLAKE EMERGENCY ROOM PROVIDERS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-472-8800
Mailing Address - Street 1:WESTLAKE EMERGENCY ROOM PROVIDERS, SC
Mailing Address - Street 2:DEPT 10303, PO BOX 87618
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-0618
Mailing Address - Country:US
Mailing Address - Phone:630-472-8800
Mailing Address - Fax:630-472-9502
Practice Address - Street 1:WESTLAKE COMMUNITY HOSPITAL
Practice Address - Street 2:1225 W. LAKE STREET
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-4039
Practice Address - Country:US
Practice Address - Phone:708-681-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty