Provider Demographics
NPI:1053704577
Name:NORTHWEST COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:NORTHWEST COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-618-5018
Mailing Address - Street 1:800 W CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2349
Mailing Address - Country:US
Mailing Address - Phone:847-618-1000
Mailing Address - Fax:847-618-5009
Practice Address - Street 1:800 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2349
Practice Address - Country:US
Practice Address - Phone:847-618-1000
Practice Address - Fax:847-618-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0001701273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6251175OtherAETNA
IL334OtherBLUE CROSS
IL=========401Medicaid
IL6251175OtherAETNA
IL6251175OtherAETNA
IL0627990001Medicare NSC