Potential human exposure to rabies is reportable in Illinois. A syndromic surveillance system containing emergency department (ED) records from 45 hospitals in Cook County was queried for visits pertaining to bat contact or rabies post exposure prophylaxis (PEP) from 1/1/2013 to 6/30/2015. The extracted records were matched on demographics to cases reported to the Cook County Department of Public Health (CCDPH). Of 241 individuals under CCDPH jurisdiction visiting local EDs for bat contact or rabies PEP, 63 (26%) were reported. Differential reporting completeness among institutions was observed. New procedures for active surveillance of potential rabies exposures were instituted at CCDPH.