Healthcare Provider Details

I. General information

NPI: 1720005630
Provider Name (Legal Business Name): NEUROSCIENCES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 S MICHIGAN AVE STE 1407
CHICAGO IL
60603-6213
US

IV. Provider business mailing address

4950 S CHICAGO BEACH DR C/O DR. KOHN
CHICAGO IL
60615-3204
US

V. Phone/Fax

Practice location:
  • Phone: 312-443-0099
  • Fax: 312-896-5174
Mailing address:
  • Phone: 312-479-7883
  • Fax: 312-896-5174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036055527
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036055527
License Number StateIL

VIII. Authorized Official

Name: NORMAN V KOHN
Title or Position: PRESIDENT
Credential: MD
Phone: 312-443-0099