Healthcare Provider Details

I. General information

NPI: 1043261449
Provider Name (Legal Business Name): STUART COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 HALIGUS RD
HUNTLEY IL
60142-9553
US

IV. Provider business mailing address

2540 WINDY HILL RD SE
MARIETTA GA
30067-8605
US

V. Phone/Fax

Practice location:
  • Phone: 815-759-4323
  • Fax: 224-654-0000
Mailing address:
  • Phone: 470-644-1274
  • Fax: 470-644-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number009801621
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number43907
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD471946
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA08931500
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number23574
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0058794
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD09886
License Number StateRI
# 8
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036159222
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: