Cook County

NPI #1700400744 in Blue Island, Illinois

Provider Information

NPI Number: 1700400744
Entity Type: Organization
Organization Name: Cook County
Subpart: Yes (part of a larger organization)
Parent Organization: COOK COUNTY
Primary Specialty: Family Medicine
Enumeration Date: Jun 5, 2020
Last Updated: Jun 5, 2020

Practice Location

Address: 12757 SOUTH WESTERN AVENUE
City: Blue Island
State: Illinois
ZIP Code: 60406
Phone: (312) 864-0200

Authorized Official

Name: SCOTT ANDRLE
Title: DIRECTOR OF MANAGED OPERATIONS
Phone: (312) 864-4649

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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