NPIMap

Organization Active NPI

Glenbrook Hospital

  • General Acute Care Hospital
  • Evanston, IL
National Provider Identifier
1619143997
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
085000949 Issued in IL
Legal business name
GLENBROOK HOSPITAL
Practice address
2650 Ridge Ave
Room 1223
Evanston, IL 60201-1718
Phone
(847) 570-1644
Fax
(847) 733-5315
NPI assigned
May 6, 2008
Last updated
May 6, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
EVANSTON NORTHWESTERN HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul Edward West III, P.A.
Title
Physician Assistant
Phone
(847) 657-5815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 085000949 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Room 1223
Evanston, IL 60201-1718

Mailing address

2650 Ridge Ave
Room 1223
Evanston, IL 60201-1718
Phone (847) 570-1644

National Provider Directory

National Provider Directory
Tax ID family
David J Knudtson MD4 organizations share this tax ID, including this one
Part of
David J Knudtson MD

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2650 Ridge Ave
Rm 1223
Evanston, IL 60201
Phone (847) 570-1644

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1619143997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "ROOM 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1644",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "ROOM 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1644",
            "fax_number": "847-733-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENBROOK HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVANSTON NORTHWESTERN HEALTHCARE",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "847-657-5815",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "085000949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.