Organization
NORTHWESTERN MEDICAL FACULTY FOUNDATION
Active
Parent organization
NORTHWESTERN MEDICAL GROUP
Other names
NMG Otolaryngology Head And Neck Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWESTERN MEDICAL GROUP
Authorized official
MR. RUSSELL B COX (DIRECTOR)
(312) 695-7860
Entity
Organization
Contact information
Practice address
675 N SAINT CLAIR ST, SUITE 15-200, CHICAGO, IL 60611-5975
(312) 695-8182
(312) 695-4303
Mailing address
680 N LAKE SHORE DR, SUITE 1000, CHICAGO, IL 60611-4546
(312) 695-9797
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
02/22/2017
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