Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 036057091 | ID |
NPI | 1548238975 |
---|---|
Provider Name | Dr. Richard A Cohn |
First Address | Skokie, IL 60076-1920 |
Second Address | Skokie, IL 60076-1920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 29/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036057091 | (05) | IL |
AC8327290 | DEA (01) | |
E24503 | (02) |