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General NPI Number Information
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NPI Number | 1821278938
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Entity Type | Organization
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Legal Business Name | COOK COUNTY
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 1901 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3714
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Country | US
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Telephone | 312-864-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 W POLK ST ROOM G-16
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City | CHICAGO
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State | IL
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Zip | 60612-3723
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Country | US
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Telephone | 312-864-6000
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. KELVIN O MAGEE
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Credential |
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Telephone | 312-864-4686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 0005272
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License Number State | IL
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