Provider Demographics
NPI:1467946913
Name:COOK COUNTY HEALTH & HOSPITAL SYSTEMS
Entity Type:Organization
Organization Name:COOK COUNTY HEALTH & HOSPITAL SYSTEMS
Other - Org Name:COOK COUNTY HEALTH & HOSPITAL SYSTEMS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PGY1
Authorized Official - Prefix:DR
Authorized Official - First Name:CARDILLIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-864-0618
Mailing Address - Street 1:1901 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3714
Mailing Address - Country:US
Mailing Address - Phone:312-864-6000
Mailing Address - Fax:
Practice Address - Street 1:1901 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125072983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty