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NPI 1700289121

NPI 1700289121 : CHRISTINA COOK : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1700289121
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINA COOK
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/30/2014
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    Last Update Date     |    10/02/2025
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Provider Practice Location Address
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    Address Line         |    66 W OAK ST 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60610-7325
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    Country              |    US
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    Telephone            |    872-231-3162
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 74008272 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60674-8272
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    Country              |    US
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    Telephone            |    702-899-0595
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    Fax                  |    702-977-1496
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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        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    
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    License Number State |    
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