# NORTHWESTERN MEMORIAL HEALTHCARE

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

## Provider details

- **NPI number:** 1942690672
- **Authorized official:** MS. KELLY JO NELSON BSN, MSN, FNP (NURSE PRACTITONER)
- **Authorized official phone:** (847) 471-3513

## Contact information

- **Practice address:** 1030 N WOLCOTT AVE, CHICAGO, IL 60622-5986
- **Practice address phone:** (847) 471-3513
- **Mailing address:** 1030 N WOLCOTT AVE, CHICAGO, IL 60622-5986
- **Mailing address phone:** (847) 471-3513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | 209012197 | IL | Yes |

## Other

- **Enumeration date:** 02/03/2015
- **Last updated:** 02/03/2015