NPIMap

Organization Active NPI

Cook County

  • Primary Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1124148366
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0005272 Issued in IL
Legal business name
COOK COUNTY
Practice address
3410 W Van Buren St
Chicago, IL 60624-3358
Phone
(773) 265-2800
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandra Ankebrant
Title
Coo
Phone
(312) 864-0719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0005272 IL Primary

Addresses

Primary practice location

3410 W Van Buren St
Chicago, IL 60624-3358

Mailing address

1110 S Oakley Blvd
Room 200
Chicago, IL 60612-4218
Phone (312) 864-4665

Other names 1

  • WESTSIDE HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Triage Center67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

1110 S Oakley Blvd
Rm 200
Chicago, IL 60612

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124148366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S OAKLEY BLVD",
            "address_2": "ROOM 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124218",
            "telephone_number": "312-864-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 W VAN BUREN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243358",
            "telephone_number": "773-265-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANKEBRANT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "312-864-0719"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "0005272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WESTSIDE HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.