Provider Demographics
| NPI: | 1134433154 |
|---|---|
| Name: | NORTHWEST COMMUNITY HEALTH SERVICES INC |
| Entity type: | Organization |
| Organization Name: | NORTHWEST COMMUNITY HEALTH SERVICES INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF OPERATING OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MICHAEL |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HARTKE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 877-635-9229 |
| Mailing Address - Street 1: | 3040 W SALT CREEK LN |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ARLINGTON HEIGHTS |
| Mailing Address - State: | IL |
| Mailing Address - Zip Code: | 60005-1069 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 847-618-3481 |
| Mailing Address - Fax: | 847-618-3489 |
| Practice Address - Street 1: | 3040 W SALT CREEK LN |
| Practice Address - Street 2: | |
| Practice Address - City: | ARLINGTON HEIGHTS |
| Practice Address - State: | IL |
| Practice Address - Zip Code: | 60005-1069 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 847-618-3481 |
| Practice Address - Fax: | 847-618-3489 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-08-02 |
| Last Update Date: | 2021-03-17 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2084V0102X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| IL | 1467057513 | Other | GROUP NPI |
| IL | IL3967 | Medicare PIN |
