# NORTHWEST SUBURBAN COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770504789
- **Authorized official:** MR. LAURENCE HENRY LENZ JR. (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (734) 547-1114

## Contact information

- **Practice address:** 1625 S STATE ST, BELVIDERE, IL 61008-5907
- **Practice address phone:** (815) 547-5441
- **Practice address fax:** (815) 544-0517
- **Mailing address:** 135 S PROSPECT ST, YPSILANTI, MI 48198-7914
- **Mailing address phone:** (734) 547-1114
- **Mailing address fax:** (734) 547-1145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 0004820 | IL | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 08/22/2020