MEDICARE: MICHAL COHEN PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1588440028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAL COHEN PLLC

Provider Business Mailing Address
First Line	:	2949 W COYLE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2923
Country	:	US
Telephone Number	:	773-339-7773
Fax Number	:

Provider Business Practice Location Address
First Line	:	2949 W COYLE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2923
Country	:	US
Telephone Number	:	773-339-7773
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	MICHAL COHEN
Credential	:	LCSW
Telephone Number	:	773-339-7773

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	08/31/2023

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