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Organization

NORTHWESTERN MEMORIAL PHYSICIANS GROUP

Active
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Organization

NORTHWESTERN MEMORIAL PHYSICIANS GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CYNTHIA KNOLL (VICE PRESIDENT OF OPERATIONS)
(312) 926-6147
Entity
Organization

Contact information

Practice address
1460 N HALSTED ST, SUITE 502, CHICAGO, IL 60642-2605
(312) 926-7028
Mailing address
1460 N HALSTED ST, SUITE 502, CHICAGO, IL 60642-2605

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
036095919
IL

Other

Enumeration date
09/15/2011
Last updated
09/15/2011
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