Provider Demographics
NPI:1578932869
Name:NORTHWEST COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:NORTHWEST COMMUNITY HOSPITAL
Other - Org Name:NCH BREAST CENTER AT ARLINGTON HEIGHTS ROAD
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:O
Authorized Official - Last Name:SCOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-618-5000
Mailing Address - Street 1:1410 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4822
Mailing Address - Country:US
Mailing Address - Phone:847-221-4200
Mailing Address - Fax:847-221-4296
Practice Address - Street 1:1410 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4822
Practice Address - Country:US
Practice Address - Phone:847-221-4200
Practice Address - Fax:847-221-4296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0001701282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL334OtherBLUE CROSS
IL334OtherBLUE CROSS
IL140252Medicare Oscar/Certification