COOK COUNTY (NPI# 1780205708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780205708 |
| Entity Type | Organization |
| Organization Name | COOK COUNTY |
| Practice Address |
12757 S. Western Ave Blue Island IL 60406 |
| Mailing Address |
1900 W Polk St Ste 220c Chicago IL 60612-3723 |
| Practice Telephone | 7082938400 |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |
| Authorized Official Name | SCOTT ANDRLE (DIRECTOR OF MANAGED CARE) |
| Authorized Official Telephone | 3128644649 |
| Is Organization Subpart | Y |
| Parent Organization Name | COOK COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Cook County Health at Blue Island | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170221 | Cook County | Technician, Other | 430 East 51st Pl, Chicago, IL 60615 | 2020-09-28 |
| 1457982340 | Cook County | Family Medicine | 15900 S. Cicero, Oak Forest, IL 60452 | 2020-01-29 |
| 1841500956 | Cook County | Pharmacy | 1901 W Harrison St Rm B178, Chicago, IL 60612-3714 | 2010-10-08 |
| 1770892135 | Cook County | Pharmacy | 1901 W Harrison St Rm 1230a, Chicago, IL 60612-3714 | 2010-10-04 |
| 1982724894 | Cook County | Clinic/Center | 450 E 51st St, Chicago, IL 60615 | 2007-04-02 |
| 1346360682 | Cook County | General Acute Care Hospital | 15900 Cicero, Oak Forest, IL 60452 | 2007-03-30 |
| 1194845495 | Cook County | Clinic/Center | 4859 S Wabash Ave, Chicago, IL 60615-1008 | 2007-03-30 |
| 1649390022 | Cook County | Clinic/Center | 12757 South Western Avenue, Blue Island, IL 60406 | 2007-03-30 |
| 1295855096 | Cook County | Clinic/Center | 1135 W 69th St, Chicago, IL 60621-1147 | 2007-03-29 |
| 1861512667 | Cook County | Clinic/Center | 2424 S Pulaski Rd, Chicago, IL 60623-3718 | 2007-03-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | COOK COUNTY APARTMENTS LLC | 1515 Sw 5th Ave Ste 600, Portland, OR 97201 |
| System for Award Management (SAM) Entities | COOK COUNTY BLACK CHAMBER OF COMMERCE CORPORATION | 732 N Spaulding Ste 1r, Chicago, IL 60624-1541 |
| System for Award Management (SAM) Entities | COOK COUNTY BOARD OF HEALTH | 204 N Parish, Adel, GA 31620-2327 |
| System for Award Management (SAM) Entities | COOK COUNTY DEPT OF PUBLIC HEALTH | 15900 S Cicero Ave, Oak Forest, IL 60452 |
| System for Award Management (SAM) Entities | COOK COUNTY ELEMENTARY SCHOOL | 12300 S Greenwood Ave, Blue Island, IL 60406-1558 |
| System for Award Management (SAM) Entities | COOK COUNTY HEALTH | 1950 W Polk St, Chicago, IL 60612-3723 |
| System for Award Management (SAM) Entities | COOK COUNTY J T D C FOUNDATION | 1538 W Jackson Blvd, Chicago, IL 60607-5304 |
| System for Award Management (SAM) Entities | COOK COUNTY SOUTHLAND JUVENILE JUSTICE COUNCIL | 336 Forest Blvd, Park Forest, IL 60466-2005 |
| System for Award Management (SAM) Entities | COOK COUNTY SUBURBAN REDEVELOPMENT, LLC | 175 West Jackson Blvd, Chicago, IL 60604-2615 |
| Street Address |
12757 S. WESTERN AVE |
| City | BLUE ISLAND |
| State | IL |
| Zip Code | 60406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942842810 | Blue Island Smiles PC | Dentist | 12059 Western Avenue, Blue Island, IL 60406 | 2019-10-12 |
| 1609438738 | Maisha Safford | Developmental Therapist | 2262 W. 120th Place, Blue Island, IL 60406 | 2019-06-28 |
| 1891279709 | Renjith Thomas | Physical Therapy Assistant | Therapy Department, 1546 W Water Stret, Blue Island, IL 60406 | 2018-09-18 |
| 1982182994 | Lifehouse Health Group,llc | Clinic/Center | 14127 Levitt Ave, Dixmoor, IL 60406 | 2018-08-01 |
| 1063923159 | Sarah Lynn Presser | Speech-Language Pathologist | 2975 W Broadway, Blue Island, IL 60406 | 2017-10-17 |
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1427429141 | Pamela Kilcrease | Case Manager/Care Coordinator | 2247 119th Street, Apt 6, Blue Island, IL 60406 | 2015-10-08 |
| 1639587025 | D2 Dental At Oak Street, P.C. | Dentist | 3046 West 127th Street, Blue Island, IL 60406 | 2014-07-29 |
| 1700299658 | Daniel Ahrens | Optometrist | 13114 S Western Ave, Blue Island, IL 60406 | 2014-06-09 |
| 1396017984 | Abbas M.b Ibrahim Sr. | Physician Assistant | 12935 S Gregory Street, Blue Island, IL 60406 | 2012-01-30 |
| Find all providers in zip 60406 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399327 | Karen Louise Mcallister | Family Medicine | 1556 N State Rd, Flora, IL 62839-3233 | 2020-09-01 |
| 1982225918 | Welcome Health Management Group | Family Medicine | 2325 W Harrison St Apt 2, Chicago, IL 60612-3555 | 2020-04-30 |
| 1043702830 | Professional Healthcare Inc | Family Medicine | 960 Rand Rd Ste 224, Des Plaines, IL 60016 | 2018-06-06 |
| 1578078754 | Innovative Geriatrics LLC | Family Medicine | 301 Madison St Ste 310, Joliet, IL 60435-6686 | 2017-12-09 |
| 1033507249 | Bridgecare, Inc. | Family Medicine | 2250 E Devon Ave, Suite 333, Des Plaines, IL 60018-4511 | 2014-12-23 |
| 1700218385 | Camilla Lim | Family Medicine | 309 Ridgemoor Dr, Willowbrook, IL 60527-5416 | 2013-08-06 |
| 1073807707 | Lr Health Management, Inc | Family Medicine | 1204 S 57th Ave, Cicero, IL 60804-1148 | 2011-05-28 |
| 1770884561 | Dr Gandhi Inc | Family Medicine | 1404 English Ct, Naperville, IL 60564-5187 | 2010-11-10 |
| 1285941914 | Shifa Medical Care, Inc | Family Medicine | 142 E Lake St, Suite C, Bloomingdale, IL 60108-1195 | 2010-09-01 |
| 1952617904 | Gerald Vincent Stanton | Family Medicine | 21505 W Lakegreen Dr, Mundelein, IL 60060-5000 | 2010-08-27 |
| Find all providers with the same taxonomy | ||||
| City | BLUE ISLAND |
| Zip Code | 60406 |
Please comment or provide details below to improve the information on COOK COUNTY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.