COOK COUNTY is a renal dialysis technician other in Chicago, IL. COOK COUNTY NPI is 1578170221. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Provident Dialysis Center.
The provider's business location address is:
430 EAST 51ST PL
CHICAGO, IL
ZIP 60615
Phone: (312) 864-0200
The provider's authorized official is Scott Andrle .
The authorized official title is Director Of Managed Care and has the following contact phone number (312) 864-4649.
The enumeration date for this NPI number is 9/28/2020 and was last updated on 3/16/2022.