Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 036062797 | IL |
NPI | 1043289234 |
---|---|
Provider Name | Susan Lerner Cohn |
First Address | Chicago, IL 60637-1447 |
Second Address | Chicago, IL 60637-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036062797 | (05) | IL |
E24493 | (02) |