Provider Demographics
NPI:1023075306
Name:NORTHWEST ORTHOPAEDIC ASSOC LTD
Entity type:Organization
Organization Name:NORTHWEST ORTHOPAEDIC ASSOC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT NORTHWEST ORTHOPAEDICS PH
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
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 AVENUE
Mailing Address - Street 2:NORTHWEST ORTHOPAEDIC ASSOCIATES LTD SUITE 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:773-631-3005
Practice Address - Street 1:7447 W TALCOTT AVENUE
Practice Address - Street 2:NORTHWEST ORTHOPAEDIC ASSOCIATES LTD SUITE 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:773-631-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0021604007OtherBSIL
ILCN2029OtherRAILROAD MEDICARE
IL0021604007OtherBSIL
H76297Medicare UPIN
D12588Medicare UPIN
F29712Medicare UPIN
F42989Medicare UPIN
ILCN2029OtherRAILROAD MEDICARE
C41898Medicare UPIN
D15047Medicare UPIN