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General NPI Number Information
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NPI Number | 1053964395
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Entity Type | Individual
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Provider Name | GREGORY ROBERT COOK JR. APRN, CNP
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Gender | Male
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 676 N SAINT CLAIR ST STE 2100
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City | CHICAGO
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State | IL
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Zip | 60611-2993
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Country | US
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Telephone | 312-695-1800
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Fax | 312-695-4741
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Provider Business Mailing Address
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Address Line | 676 N SAINT CLAIR ST STE 2100
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City | CHICAGO
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State | IL
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Zip | 60611-2993
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Country | US
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Telephone | 312-695-1800
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Fax | 312-695-4741
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209027656
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11003002
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License Number State | FL
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