Cook County | |
12757 South Western Avenue Blue Island IL 60406 | |
(312) 864-0200 | |
Not Available |
Full Name | Cook County |
---|---|
Speciality | Family Medicine |
Location | 12757 South Western Avenue, Blue Island, Illinois |
Authorized Official Name and Position | Scott Andrle (DIRECTOR OF MANAGED OPERATIONS) |
Authorized Official Contact | 3128644649 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Cook County 1900 W Polk St Ste 220c Chicago IL 60612-3723 Ph: () - | Cook County 12757 South Western Avenue Blue Island IL 60406 Ph: (312) 864-0200 |
NPI Number | 1700400744 |
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Provider Enumeration Date | 06/05/2020 |
Last Update Date | 06/05/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700400744 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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