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NPI Code Detail

MEDICARE: COOK COUNTY

MEDICARE: COOK COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0002XClinic Pharmacy054014914IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12021374OTHERPK

General Provider Information

NPI Number : 1013035781
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOK COUNTY
Provider Business Mailing Address
First Line : 1901 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-6189
Fax Number : 312-864-9288
Provider Business Practice Location Address
First Line : 1901 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-6189
Fax Number : 312-864-9288
Authorized Official
Title or Position : ASSISTANT DIRECTOR OF PHARMACY
Name : JOHN BUSKER
Credential :
Telephone Number : 312-864-2194
Provider Enumeration Date : 03/27/2007
Last Update Date : 04/25/2016

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Directions to “COOK COUNTY ” Practice Location

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