Active NPI
Cook County
Doing business as Bronzeville Health Center
- Multi-Specialty Clinic/Center
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- COOK COUNTY
- Doing business as
- Bronzeville Health Center
- Practice address
- 467 East 31St Street
Chicago, IL 60616 - Phone
- (312) 864-0200
- NPI assigned
- Mar 29, 2007
- Last updated
- Aug 6, 2024
- Organization subpart
- Yes
- Parent organization
- COOK COUNTY
NPPES NPI Registry
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
- Phone
- (312) 864-4649
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
467 East 31St Street
Chicago, IL 60616
Mailing address
467 East 31St Street
Chicago, IL 60616
Other names 1
- Bronzeville Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100216000401 | IL | Part A Provider - Hospital | 2860398088 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chicago, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1831219450. Details of each certification follow.
Hospital certification: CCN 140300
- Legal name
- COOK COUNTY
- Doing business as
- PROVIDENT HOSPITAL OF COOK COUNTY
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 8, 1993
- Last certification
- Jul 2, 2005
- Beds
- 222
- Ownership / control type
- Local
- Organization structure
- Government
- Incorporated
- Jan 1, 1866 in IL
- Enrollment address
- 500E 51St St
Chicago, IL 60615-2400 - Hospital subgroups
- Acute care
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba John Sengstacke Health Center (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1235760224
O20100216000401
-
dba Cook County Health - P -UA
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1477021913
O20100216000401
-
dba Provident Hospital of Cook County
- General Acute Care Hospital
- Chicago, IL
- NPI 1487664561
O20100216000401
-
dba Provident Hospital of Cook County
- Clinic Pharmacy
- Chicago, IL
- NPI 1588781298
O20100216000401
Care Compare: Hospital
Medicare Care Compare- Listed as
- Provident Hospital of Chicago
- Type
- Acute Care Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Community Triage Center
- Part of
- Community Triage Center
Organizations with this tax ID in the same state 23
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Behavioral Health Agency
- Chicago, IL
- NPI 1922549294
-
- Public Health or Welfare Agency
- Chicago, IL
- NPI 1700051448
-
dba Cook County Health at Blue Island
- Family Medicine Physician
- Blue Island, IL
- NPI 1700400744
-
dba Children's Advocacy Center (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1740811736
-
dba Logan Square Health Center (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1750912648
-
dba John H. Stroger, Jr. Hospital BC Outpatient Pharmacy
- Institutional Pharmacy
- Chicago, IL
- NPI 1770892135
-
dba Cook County Health at Blue Island
- Geriatric Medicine (Family Medicine) Physician
- Blue Island, IL
- NPI 1780205708
-
dba Central Campus Specialty Care Clinic (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1790316784
-
dba John H. Stroger, Jr. Hospital of Cook County
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Chicago, IL
- NPI 1821278938
-
dba Provident Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Chicago, IL
- NPI 1831846922
Locations
1110 S Oakley Blvd
Rm 200
Chicago, IL 60612
231 N Pine Ave
Chicago, IL 60644
Phone (773) 287-9770
231 N Pine Ave
#133B
Chicago, IL 60644
231 N Pine Ave
Ste 133B
Chicago, IL 60644
Phone (773) 854-3827
2653 W Ogden Ave
Chicago, IL 60608
Phone (773) 257-6672
3435 W Van Buren St
Fl 5
Chicago, IL 60624
Phone (773) 265-5050
4800 W Chicago Ave
Ste 1
Chicago, IL 60651
Phone (773) 826-9600
621 S Winchester Ave
Chicago, IL 60612
Phone (312) 633-7292
7050 S May St
Chicago, IL 60621
Phone (773) 723-3766
730 N Pulaski Rd
Rm 103
Chicago, IL 60624
Phone (773) 534-8924
1645 Cottage Grove Ave
Ford Heights, IL 60411
Phone (708) 753-5800
1585 N Rand Rd
Palatine, IL 60074
Phone (847) 934-7969
13450 S Kedzie Ave
Robbins, IL 60472
Phone (708) 293-8100
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Eze Peter Nwaezeigwe | Corporate Director | Nov 13, 2018 | |
| W-2 Managing Employee | Nov 13, 2018 | ||
| Cook County | 5% Or Greater Direct Ownership Interest | Aug 17, 1993 | 100% |
| Scott Spencer | Corporate Officer | Dec 29, 2025 | |
| W-2 Managing Employee | Dec 29, 2025 | ||
| Michael Sumrall | W-2 Managing Employee | Jun 22, 2016 |
Owners & managing parties with NPI records 4
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Provident Hospital of Cook County
- General Acute Care Hospital
- Chicago, IL
- NPI 1487664561
5% Or Greater Direct Ownership Interest
-
dba Provident Dialysis Center
- Renal Dialysis Technician
- Chicago, IL
- NPI 1578170221
5% Or Greater Direct Ownership Interest
-
dba John H. Stroger, Jr. Hospital of Cook County
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
5% Or Greater Direct Ownership Interest
-
dba John H. Stroger, Jr. Hospital of Cook County
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Chicago, IL
- NPI 1821278938
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Practitioners 1,735
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Cardiovascular Disease Physician
- Hazel Crest, IL
- NPI 1255495701
-
- Colon & Rectal Surgery Physician
- Chicago, IL
- NPI 1831364272
-
- Neurology with Special Qualifications in Child Neurology Physician
- Springfield, IL
- NPI 1972543080
-
- Pediatric Cardiology Physician
- Chicago, IL
- NPI 1710037742
-
- Infectious Disease Physician
- Oak Forest, IL
- NPI 1871596817
-
- Family Medicine Physician
- Frankfort, IL
- NPI 1407086515
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1548724578
-
- Nephrology Physician
- Chicago, IL
- NPI 1144550088
-
- Gastroenterology Physician
- Chicago, IL
- NPI 1447274279
-
- Obstetrics & Gynecology Physician
- Chicago, IL
- NPI 1245351824
-
- Otolaryngology Physician
- Chicago, IL
- NPI 1386104891
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Chicago, IL
- NPI 1295840304
Affiliated clinicians 166
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722902400000",
"number": "1831219450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "467 EAST 31ST STREET",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "467 EAST 31ST STREET",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60616",
"telephone_number": "312-864-0200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COOK COUNTY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COOK COUNTY",
"enumeration_date": "2007-03-29",
"last_updated": "2024-08-06",
"certification_date": "2024-08-01",
"status": "A",
"authorized_official_last_name": "ANDRLE",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
"authorized_official_telephone_number": "312-864-4649"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Bronzeville Health Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bronzeville Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Chicago, IL
- Cook County (Logan Square Health Center (FFS))
- Cook County (John H. Stroger, Jr. Hospital BC Outpatient Pharmacy)
- Cook County (Central Campus Specialty Care Clinic (FFS))
- Cook County (John H. Stroger, Jr. Hospital of Cook County)
- Cook County (Cook County Health & Hospitals System Physician Services)
- Cook County (Provident Dialysis Center)
- Cook County (Fantus Health Center Refill Pharmacy)
- Cook County (Jorge Prieto Health Center)
- Cook County (Ruth M Rothstein CORE Center)
- Cook County (Harrison Square FAO)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.