Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 070015295 | IL |
NPI | 1013152628 |
---|---|
Provider Name | Ms. Jennifer S Cohen |
First Address | Glenview, IL 60026-8043 |
Second Address | Glenview, IL 60026-8043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2008 |
Last Update Date | 18/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1617235 | BCBS (01) | IL |