Healthcare Provider Details

I. General information

NPI: 1023273901
Provider Name (Legal Business Name): JONATHAN C COTTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21202 OWENS RD STE 300
MOKENA IL
60448-2038
US

IV. Provider business mailing address

21202 OWENS RD STE 300
MOKENA IL
60448-2038
US

V. Phone/Fax

Practice location:
  • Phone: 779-334-0100
  • Fax: 779-334-0051
Mailing address:
  • Phone: 779-334-0100
  • Fax: 779-334-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number036136071
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036136071
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: