Organization
NORTHWESTERN MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN MANZARA (NURSE PRACTITIONER)
(630) 935-0128
Entity
Organization
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(630) 935-0128
Mailing address
251 E HURON ST, CHICAGO, IL 60611-2908
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
209009062
IL
363LA2200X
Adult Health Nurse Practitioner
209009062
IL
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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