Provider Demographics
NPI:1144246059
Name:NORTHWEST ORTHOPAEDIC ASSOCIATES, LTD
Entity type:Organization
Organization Name:NORTHWEST ORTHOPAEDIC ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REP
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-631-7898
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:STE. 500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-631-7898
Mailing Address - Fax:
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:STE. 500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-631-7898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0242720001Medicare NSC
IL382600Medicare PIN