Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 036-083810 | IL |
NPI | 1003954066 |
---|---|
Provider Name | Dr. Robert G Kohn |
First Address | Mchenry, IL 60050-4007 |
Second Address | Mchenry, IL 60050-7012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 13/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5626836 | BCBS-NEUROLOGY (01) | IL |
C50914 | (02) | IL |