MEDICARE: CHERISE COKLEY MD

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	208M00000X	Hospitalist Physician	036122043	IL
2	207V00000X	Obstetrics & Gynecology Physician	036122043	IL

General Provider Information

NPI Number	:	1285835025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERISE COKLEY MD

Provider Business Mailing Address
First Line	:	1129 BRASSIE AVE
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-1503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5145 N CALIFORNIA AVE FL 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3687
Country	:	US
Telephone Number	:	773-989-3834
Fax Number	:	773-275-2433

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	04/03/2023

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Directions to “ CHERISE COKLEY MD” Practice Location

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