Organization
COOK COUNTY
Active
Parent organization
COOK COUNTY
Other names
Central Campus Specialty Care Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOK COUNTY
Authorized official
MR. SCOTT ANDRLE (DIRECTOR MANAGED CARE)
(312) 864-4649
Entity
Organization
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-4649
Mailing address
1900 W POLK ST STE 220C, CHICAGO, IL 60612-3723
(312) 864-4649
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
0005272
IL
Other
Enumeration date
03/29/2007
Last updated
06/06/2022
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