NPIMap

Organization Active NPI

Cook County

  • Primary Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1497874325
Registry record updated Feb 22, 2019
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
6337 S Woodlawn Ave
Chicago, IL 60637-3707
Phone
(773) 753-5500
NPI assigned
Mar 29, 2007
Organization subpart
Yes
Parent organization
COOK COUNTYAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Scott Andrle
Title
Director of Managed Care Operations
Phone
(312) 864-4649

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031209000747 IL Part B Supplier - Clinic/Group Practice 2860398088 Receives reassigned benefits from 1,783 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL; Ford Heights, IL; North Riverside, IL; Robbins, IL; Arlington Heights, IL

National Provider Directory

National Provider Directory
Tax ID family
Community Triage Center (67 organizations share this tax ID)
Part of
Community Triage Center

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

6337 S Woodlawn Ave
Chicago, IL 60637-3707

Mailing address

1900 W Polk St RM 220C
Chicago, IL 60612-3723
Phone (312) 864-4649

Other names 1

NPPES NPI Registry
  • WOODLAWN HEALTH CENTER Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 22, 2019.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1497874325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST RM 220C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 S WOODLAWN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606373707",
            "telephone_number": "773-753-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOK COUNTY",
        "enumeration_date": "2007-03-29",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "ANDRLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE OPERATIONS",
        "authorized_official_telephone_number": "312-864-4649"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "0005272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOODLAWN HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WOODLAWN 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 Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.