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General NPI Number Information
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NPI Number | 1902437510
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Entity Type | Individual
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Provider Name | PHILIP JAMES COOKE PHD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2020
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 1700 W IRVING PARK RD STE 305B
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City | CHICAGO
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State | IL
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Zip | 60613-2462
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Country | US
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Telephone | 773-769-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 1232 W HOOD AVE APT 1
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City | CHICAGO
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State | IL
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Zip | 60660-1994
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Country | US
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Telephone | 301-661-1166
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Fax |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 071.010233
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License Number State | IL
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