Cook County
Clinic/Center, Primary Care in Chicago, IL. Organization (NPI-2).
NPI number1124148366
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1124148366
- Entity type
- Organization (NPI-2)
- Legal business name
- Cook County
- Organization subpart
- No
- Enumeration date
- Mar 30, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 0005272 | IL | Yes |
Other names
- Westside Health Center (Doing Business As)
Practice location
3410 W Van Buren StChicago, IL 60624-3358
Phone 773-265-2800
Mailing address
1110 S Oakley BlvdRoom 200
Chicago, IL 60612-4218
Phone 312-864-4665
Authorized official
Sandra Ankebrant
Coo
3128640719
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