Organization · Type 2 NPI

Cook County

Multi-Specialty Clinic/Center · Blue Island, IL

NPI number 1649390022 Active

Practice location

12757 South Western Avenue
Blue Island, IL 60406

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center Primary	261QM1300X	0001743 (IL)

Multi-Specialty Clinic/Center: Definition to come...

Another provider at this address

Cook CountyFamily Medicine Physician Blue Island, IL NPI 1700400744

Other multi-specialty clinic/center providers in Blue Island

Dupage Medical Group, LtdMulti-Specialty Clinic/Center Blue Island, IL NPI 1700839230

See all in Blue Island →

NPI record

NPI: 1649390022
Entity type: Organization (Type 2)
Issued: Mar 30, 2007
Last updated: Jan 25, 2022
Status: Active
Subpart: Yes of Cook County

Other names

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Cook County Health at Blue Island · doing business as

Authorized official

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

Verify this record

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 1649390022

Cook County's National Provider Identifier is 1649390022, issued on Mar 30, 2007. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Blue Island, IL. The record was last updated on Jan 25, 2022.