Physician Compare National (NPI:1104814912)

HEALTHCARE PROVIDER: J WESLEY COOK D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1104814912
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698809952
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100823000594
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COOK
	Individual professional last name
Provider First Name	J
	Individual professional first name
Provider Middle Name	WESLEY
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ADDICTION MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	OSTEOPATHIC MANIPULATIVE MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ADDICTION MEDICINE, OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2001 W ADDISON ST
	Group Practice or individual's line 1 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606186132
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7734041000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y