Provider Demographics
NPI:1346235314
Name:NORTHWESTERN MEDICAL FACULTY FOUNDATION
Entity type:Organization
Organization Name:NORTHWESTERN MEDICAL FACULTY FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRZEMINSKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-926-2000
Mailing Address - Street 1:DEPT 5777
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWESTERN MEMORIAL HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-15
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL799310Medicare ID - Type Unspecified
IL720150Medicare ID - Type Unspecified
IL522620Medicare ID - Type UnspecifiedOUR MAIN MEDICARE GROUP #
IL522623Medicare ID - Type Unspecified
IL961460Medicare ID - Type Unspecified