# NORTHWESTERN MEMORIAL HOSPITAL

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

## Provider details

- **NPI number:** 1912283268
- **Authorized official:** LAUREN MANZARA (NURSE PRACTITIONER)
- **Authorized official phone:** (630) 935-0128

## Contact information

- **Practice address:** 251 E HURON ST, CHICAGO, IL 60611-2908
- **Practice address phone:** (630) 935-0128
- **Mailing address:** 251 E HURON ST, CHICAGO, IL 60611-2908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 209009062 | IL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | 209009062 | IL | — |

## Other

- **Enumeration date:** 11/01/2011
- **Last updated:** 11/01/2011