Healthcare Provider Details

I. General information

NPI: 1487664561
Provider Name (Legal Business Name): COOK COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 EAST 51ST STREET
CHICAGO IL
60615-2494
US

IV. Provider business mailing address

500 EAST 51ST STREET
CHICAGO IL
60615-2494
US

V. Phone/Fax

Practice location:
  • Phone: 312-572-1200
  • Fax: 312-572-1294
Mailing address:
  • Phone: 312-572-1200
  • Fax: 312-572-1294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0004549
License Number StateIL

VIII. Authorized Official

Name: MR. SCOTT ANDRLE
Title or Position: DIRECTOR OF MANAGED CARE OPERATIONS
Credential:
Phone: 312-864-4649