MEDICARE: TODD COX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1295299089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD COX

Provider Business Mailing Address
First Line	:	741 W ADAMS ST
Second Line	:
City	:	NASHVILLE
State	:	IL
Zip	:	62263-1336
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	741 W ADAMS ST
Second Line	:
City	:	NASHVILLE
State	:	IL
Zip	:	62263-1336
Country	:	US
Telephone Number	:	618-314-3678
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	01/25/2019

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Directions to “ TODD COX ” Practice Location

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