Provider Demographics
NPI:1861789877
Name:COOK COUNTY MEDICAL RESEARCH
Entity type:Organization
Organization Name:COOK COUNTY MEDICAL RESEARCH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SADHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-375-6500
Mailing Address - Street 1:PO BOX 9005
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-0005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4809 W MADISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-3640
Practice Address - Country:US
Practice Address - Phone:773-473-7800
Practice Address - Fax:773-473-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty