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General NPI Number Information
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NPI Number | 1831846922
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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 | 03/08/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 430 EAST 51ST PL
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City | CHICAGO
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State | IL
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Zip | 60615
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Country | US
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Telephone | 312-864-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 430 EAST 51ST PL
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City | CHICAGO
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State | IL
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Zip | 60615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | SCOTT ANDRLE
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Credential |
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Telephone | 312-864-4649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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