Provider Demographics
NPI:1851541049
Name:NORTHWESTERN MCGAW MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:NORTHWESTERN MCGAW MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UROLOGY RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:KHALALI
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-450-4883
Mailing Address - Street 1:4938 S DREXEL BLVD
Mailing Address - Street 2:APT 212
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2700
Mailing Address - Country:US
Mailing Address - Phone:312-450-4883
Mailing Address - Fax:
Practice Address - Street 1:4938 S DREXEL BLVD
Practice Address - Street 2:APT 212
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2700
Practice Address - Country:US
Practice Address - Phone:312-450-4883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital