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Cook County — NPI 1295855096, Chicago, IL | NPI Central

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NPI 1295855096

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Cook County

NPI 1295855096 · Primary Care Clinic/Center · Chicago, IL

Provider details

NPI number: 1295855096
Entity type: Organization
Primary specialty: Primary Care Clinic/CenterAmbulatory Health Care Facilities
Parent organization: Cook County
Organization subpart: Yes
Authorized official: Scott Andrle, Director of Managed Care Operations(312) 864-4649
License: 0005272 (IL)

Specialties & taxonomies

Primary Care Clinic/CenterPrimary261QP2300XLicense 0005272 (IL)
Ambulatory Health Care Facilities

Practice location

1135 W 69th St

Chicago, IL 60621-1147

Phone: (773) 483-5011

Approximate (ZIP-level) locationGet directions

More IL providers

Mailing address

1900 W Polk St Rm 220c

Chicago, IL 60612-3723

Other names (DBA / former)

Doing business as: Englewood Health Center

Registry dates

Enumerated: 2007-03-29
Last updated: 2022-01-25
Certified: 2022-01-25

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.