Basic Information
| Provider Information | |||||||||
| NPI: | 1043630098 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVERSITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 240 E. HURON STREET, | ||||||||
| Address2: | MCGAW PAVILION, SUTIE 1-200 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3125037975 | ||||||||
| FaxNumber: | 3125035230 | ||||||||
| Practice Location | |||||||||
| Address1: | 240 E. HURON STREET, | ||||||||
| Address2: | MCGAW PAVILION, SUTIE 1-200 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3125037975 | ||||||||
| FaxNumber: | 3125035230 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2014 | ||||||||
| LastUpdateDate: | 04/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | DUDEK | ||||||||
| AuthorizedOfficialFirstName: | ANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE OF GRADUATE MEDICAL EDUCATIO | ||||||||
| AuthorizedOfficialTelephone: | 3125037975 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QS1000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Student Health |
No ID Information.