Healthcare Provider Details

I. General information

NPI: 1548238975
Provider Name (Legal Business Name): RICHARD A COHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9036 SLEEPING BEAR RD
SKOKIE IL
60076-1920
US

IV. Provider business mailing address

9036 SLEEPING BEAR RD
SKOKIE IL
60076-1920
US

V. Phone/Fax

Practice location:
  • Phone: 847-676-0952
  • Fax:
Mailing address:
  • Phone: 847-676-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number036057091
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: