NPIMap

Organization Active NPI

Cook County

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1609407691
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COOK COUNTY
Practice address
2424 S Pulaski Rd
Chicago, IL 60623-3718
Phone
(773) 521-0750
NPI assigned
Jan 29, 2020
Organization subpart
Yes
Parent organization
COOK COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2424 S Pulaski Rd
Chicago, IL 60623-3718

Mailing address

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

Other names 1

  • Dr. Jorge Prieto Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101228000196 IL Part A Provider - Hospital 2860398088 26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arlington Heights, IL; Robbins, IL; North Riverside, IL; Ford Heights, IL; Cicero, IL; Chicago, IL; Blue Island, IL

Hospital certification: CCN 140124

Legal name
COOK COUNTY
Doing business as
JOHN H. STROGER, JR HOSPITAL OF COOK COUNTY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 12, 2016
Beds
918
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Incorporated
Jan 1, 1866 in IL
Enrollment address
1901 W Harrison St
Chicago, IL 60612-3714
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Other

Other NPIs on the same Medicare enrollment 26

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

View all 26

Care Compare: Hospital

Medicare Care Compare
Listed as
John H Stroger Jr HospitalCCN 140124
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Eze Peter Nwaezeigwe Individual Corporate DirectorDirector of Finance Nov 13, 2018
W-2 Managing EmployeeDirector of Finance Nov 13, 2018
Cook County Organization, Chicago, IL Non-profit 5% Or Greater Direct Ownership Interest Oct 27, 2010 100%
Scott Spencer Individual Corporate Officer Dec 29, 2025

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Cook County
    • General Acute Care Hospital
    • Chicago, IL
    • NPI 1487664561

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Cook County
    • Renal Dialysis Technician
    • Chicago, IL
    • NPI 1578170221

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Cook County
    • General Acute Care Hospital
    • Chicago, IL
    • NPI 1588612832

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Cook County
    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Chicago, IL
    • NPI 1821278938

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 673

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 673

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1609407691",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233718",
            "telephone_number": "773-521-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOK COUNTY",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Jorge Prieto Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr. Jorge Prieto Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.