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General NPI Number Information
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NPI Number | 1942263090
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Entity Type | Individual
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Provider Name | JUDITH A COTHRAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 4905 OLD ORCHARD CENTER SUITE 200
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City | SKOKIE
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State | IL
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Zip | 60077-1462
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Country | US
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Telephone | 847-673-3130
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Fax | 312-695-3169
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Provider Business Mailing Address
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Address Line | 4905 OLD ORCHARD CENTER SUITE 200
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City | SKOKIE
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State | IL
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Zip | 60077-1462
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Country | US
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Telephone | 847-673-3130
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Fax | 312-695-3169
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 036091412
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036-091412
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License Number State | IL
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