NORTHWEST MEDICAL ASSOCIATES SC NPI 1700066453

NPI Information

NPI: 1700066453
Provider Name: NORTHWEST MEDICAL ASSOCIATES, SC

Former Legal Business Name: CHARLOTTE MITCHELL,.M.D. S.C.

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
30 E 15TH ST
SUITE 310
CHICAGO HEIGHTS, IL
ZIP 60411
Phone: (708) 754-3225
Get Directions

NORTHWEST MEDICAL ASSOCIATES, SC is a clinic center in Chicago Heights, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). NORTHWEST MEDICAL ASSOCIATES, SC NPI is 1700066453. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Charlotte Mitchell,.m.d. S.c..

The provider's business location address is:

30 E 15TH ST
SUITE 310
CHICAGO HEIGHTS, IL
ZIP 60411-459
Phone: (708) 754-3225

The provider's authorized official is Charlotte Mitchell .
The authorized official title is Sole Owner and has the following contact phone number (708) 754-3225.

The enumeration date for this NPI number is 11/10/2007 and was last updated on 2/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		036079491	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	31603733	OTHER	ILLINOIS	BLUE CROSS
2	036079491	MEDICAID	ILLINOIS
3	924550	MEDICARE PIN	ILLINOIS
4	E47881	MEDICARE UPIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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