Organization
NORTHWEST SUBURBAN COMMUNITY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAURENCE HENRY LENZ JR. (EXECUTIVE VICE PRESIDENT)
(734) 547-1114
Entity
Organization
Contact information
Practice address
1625 S STATE ST, BELVIDERE, IL 61008-5907
(815) 547-5441
(815) 544-0517
Mailing address
135 S PROSPECT ST, YPSILANTI, MI 48198-7914
(734) 547-1114
(734) 547-1145
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0004820
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
395
BCBS PROVIDER NUMBER
—
Enumeration date
07/22/2006
Last updated
08/22/2020
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