Healthcare Provider Details

I. General information

NPI: 1922338821
Provider Name (Legal Business Name): JOHN STROGER COOK COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2009
Last Update Date: 12/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 ELDER LN
DEERFIELD IL
60015-3146
US

IV. Provider business mailing address

655 ELDER LN
DEERFIELD IL
60015-3146
US

V. Phone/Fax

Practice location:
  • Phone: 847-275-8362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number
License Number State

VIII. Authorized Official

Name: ANITA GUPTA
Title or Position: RESIDENT
Credential:
Phone: 847-275-8362