Provider Demographics
NPI:1730541699
Name:NORTHWESTERN MEDICINE
Entity type:Organization
Organization Name:NORTHWESTERN MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF REHABILITATION SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-208-5765
Mailing Address - Street 1:296 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4203
Mailing Address - Country:US
Mailing Address - Phone:630-938-6400
Mailing Address - Fax:
Practice Address - Street 1:296 RANDALL RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4203
Practice Address - Country:US
Practice Address - Phone:630-938-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital