MEDICARE: DR. JOSEPH M COSCINO PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	016-004563	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60010824	OTHER	IL	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093707796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH M COSCINO PC

Provider Business Mailing Address
First Line	:	1S067 SUMMIT AVE
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-3978
Country	:	US
Telephone Number	:	630-261-9500
Fax Number	:	630-261-9504

Provider Business Practice Location Address
First Line	:	1S067 SUMMIT AVE
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-3978
Country	:	US
Telephone Number	:	630-261-9500
Fax Number	:	630-261-9504

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	01/23/2019

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