Organization
NORTHWEST ENT ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERI ANNE GLOVER (MANAGER)
(773) 467-1469
Entity
Organization
Contact information
Practice address
7447 W TALCOTT AVE STE 316, CHICAGO, IL 60631-3714
(773) 467-1285
Mailing address
7447 W TALCOTT AVE STE 316, CHICAGO, IL 60631-3714
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360860903
—
IL
05
—
0360942493
—
IL
05
—
0361106343
—
IL
Enumeration date
08/31/2006
Last updated
08/22/2020
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