| Cottage Grove Health Center | |
|
1645 Cottage Grove Ave Ford Heights IL 60411-3818 | |
| (708) 753-5800 | |
| Not Available |
| Full Name | Cottage Grove Health Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1645 Cottage Grove Ave, Ford Heights, Illinois |
| Authorized Official Name and Position | Scott Andrle (DIRECTOR OF MANAGED CARE OPERATIONS) |
| Authorized Official Contact | 3128644649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cottage Grove Health Center 1900 W Polk St Rm 220c Chicago IL 60612-3723 Ph: (312) 864-4649 | Cottage Grove Health Center 1645 Cottage Grove Ave Ford Heights IL 60411-3818 Ph: (708) 753-5800 |
| NPI Number | 1760502439 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 02/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760502439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0001743 (Illinois) | Primary |
Cottage Grove Health Center (ffs) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1645 Cottage Grove Ave, Ford Heights, IL 60411 Phone: 708-753-5800 |