Provider Demographics
NPI:1861787939
Name:MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVERSITY
Entity type:Organization
Organization Name:MCGAW MEDICAL CENTER OF NORTHWESTERN UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAIJA
Authorized Official - Middle Name:CERS
Authorized Official - Last Name:HASIBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-926-2253
Mailing Address - Street 1:251 E HURON ST
Mailing Address - Street 2:GALTER 3-150
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-2253
Mailing Address - Fax:312-926-6905
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:GALTER 3-150
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-2253
Practice Address - Fax:312-926-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125059248261QM1300X, 2865M2000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital