Organization · Type 2 NPI

Cook County

Family Medicine Physician · Chicago, IL

NPI number 1366073256 Active

Practice location

2020 W Harrison St
Chicago, IL 60612-3741

Call (312) 864-4665 Map

Mailing address

1900 W Polk St Rm 220C
Chicago, IL 60612-3723

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

41 other providers at this address

Other family medicine physician providers in Chicago

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NPI record

NPI: 1366073256
Entity type: Organization (Type 2)
Issued: Jan 29, 2020
Last updated: Mar 2, 2020
Status: Active
Subpart: Yes of Cook County

Other names

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Ruth M. Rothstein Core Center (ffs) · doing business as
Ruth M. Rothstein Core Center (ffs) · doing business as

Authorized official

Scott Andrle
Director of Managed Care Operations
(312) 864-4649

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1366073256

Cook County's National Provider Identifier is 1366073256, issued on Jan 29, 2020. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Chicago, IL. The record was last updated on Mar 2, 2020.