Provider Demographics
NPI:1689739716
Name:COOK COUNTY
Entity Type:Organization
Organization Name:COOK COUNTY
Other - Org Name:OAK FOREST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKINHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-633-3479
Mailing Address - Street 1:15900 SOUTH CICERO AVENUE
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4000
Mailing Address - Country:US
Mailing Address - Phone:708-633-3400
Mailing Address - Fax:708-633-3407
Practice Address - Street 1:15900 SOUTH CICERO AVENUE
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4000
Practice Address - Country:US
Practice Address - Phone:708-633-3400
Practice Address - Fax:708-633-3407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOK COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-27
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0001743282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01617618OtherBCBS PHYSICIAN 1500
IL0048OtherACUTE HOSPITAL, BCBS
IL01617618OtherBCBS PHYSICIAN 1500
IL=========001Medicaid
IL814400Medicare ID - Type UnspecifiedMEDICARE PHYSICIAN