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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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1568093557
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOK COUNTY
Provider Business Mailing Address
First Line : 1900 W POLK ST RM 220C
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3723
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4800 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-3226
Country : US
Telephone Number : 773-826-9600
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF MANAGED CARE OPERATIONS
Name : SCOTT ANDRLE
Credential :
Telephone Number : 312-864-4649
Provider Enumeration Date : 01/29/2020
Last Update Date : 02/24/2026

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Directions to “COOK COUNTY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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