Provider Demographics
NPI:1447557723
Name:NORTHWESTERN UNIVERSITY
Entity Type:Organization
Organization Name:NORTHWESTERN UNIVERSITY
Other - Org Name:NORTHWESTERN UNIVERSITY HEALTH SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-491-2127
Mailing Address - Street 1:633 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60208-4000
Mailing Address - Country:US
Mailing Address - Phone:847-491-8100
Mailing Address - Fax:847-491-5919
Practice Address - Street 1:633 EMERSON ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60208-4000
Practice Address - Country:US
Practice Address - Phone:847-491-8100
Practice Address - Fax:847-491-5919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health