MEDICARE: DR. RACHEL ELAINE COHN DMD

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	1223G0001X	General Practice Dentistry		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730228255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL ELAINE COHN DMD

Provider Business Mailing Address
First Line	:	421 TOWN PLACE CIR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-6714
Country	:	US
Telephone Number	:	847-215-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-1314
Country	:	US
Telephone Number	:	773-761-2521
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/09/2007

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