Healthcare Provider Details

I. General information

NPI: 1275527848
Provider Name (Legal Business Name): ADAM BUCHANAN COCHRANE PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE MC 5026
CHICAGO IL
60637-1447
US

IV. Provider business mailing address

5020 S LAKE SHORE DR #2109
CHICAGO IL
60615-3253
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-3583
  • Fax:
Mailing address:
  • Phone: 773-702-3583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number26019213
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: