Provider Demographics
NPI:1265573836
Name:NORTHWEST COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:NORTHWEST COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:ZENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-618-5016
Mailing Address - Street 1:675 W CENTRAL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2376
Mailing Address - Country:US
Mailing Address - Phone:847-618-5250
Mailing Address - Fax:847-618-5259
Practice Address - Street 1:800 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2349
Practice Address - Country:US
Practice Address - Phone:847-618-1000
Practice Address - Fax:847-618-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336OtherBLUE CROSS SITE NUMBER