Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cook County

Organization Family Medicine Physician · NPI 1790316784

Cook County is a Family Medicine Physician in Chicago, Illinois. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

1901 W Harrison St
Chicago, IL 60612-3714
Phone: (312) 864-6126
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1790316784
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCook County
Authorized official Scott Andrle — Director Of Managed Care Operations · (312) 864-4649
Other names Central Campus Specialty Care Clinic (Ffs); Central Campus Specialty Care Clinic (Ffs)
NPI enumeratedJanuary 29, 2020
Last updated in NPPESMarch 2, 2020
Certification dateMarch 2, 2020
Mailing address1900 W Polk St Rm 220c, Chicago, IL 60612-3723

Other providers in Chicago