Provider Demographics
NPI:1588781298
Name:COOK COUNTY
Entity type:Organization
Organization Name:COOK COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARAMCY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-572-5858
Mailing Address - Street 1:500 E 51ST STREET, ROOM 2008 AND 2050
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2400
Mailing Address - Country:US
Mailing Address - Phone:312-572-5858
Mailing Address - Fax:312-572-2959
Practice Address - Street 1:500 E 51ST STREET, ROOM 2008 AND 2050
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615
Practice Address - Country:US
Practice Address - Phone:312-572-5858
Practice Address - Fax:312-572-2959
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOK COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-26
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.0172853336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2020716OtherPK
2020716OtherPK