Provider Demographics
NPI:1417619412
Name:NORTHWESTERN MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:NORTHWESTERN MEMORIAL HOSPITAL
Other - Org Name:NORTHWESTERN MEDICINE SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VICE PRESIDENT & FINANCIAL OFFIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORSINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-926-7705
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 560
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2982
Mailing Address - Country:US
Mailing Address - Phone:312-926-9365
Mailing Address - Fax:
Practice Address - Street 1:676 N SAINT CLAIR ST STE 560
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2982
Practice Address - Country:US
Practice Address - Phone:312-926-9365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy