Organization
NORTHWESTERN MEDICAL FACULTY FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA LEWIS (PRACTICE MANAGER)
(312) 695-2172
Entity
Organization
Contact information
Practice address
446 E ONTARIO ST, CHICAGO, IL 60611-4418
(312) 695-2172
Mailing address
446 E ONTARIO ST, CHICAGO, IL 60611-4418
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
209.009740
IL
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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