MEDICARE: DR. CHERYL B KRAFF COOPER M.D.

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	207W00000X	Ophthalmology Physician	036-068475	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180012409	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548207855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL B KRAFF COOPER M.D.

Provider Business Mailing Address
First Line	:	25 E WASHINGTON ST
Second Line	:	STE 606
City	:	CHICAGO
State	:	IL
Zip	:	60602-1731
Country	:	US
Telephone Number	:	773-777-4444
Fax Number	:	312-736-7873

Provider Business Practice Location Address
First Line	:	3115 N HARLEM AVE
Second Line	:	SUITE 300
City	:	CHICAGO
State	:	IL
Zip	:	60634-4684
Country	:	US
Telephone Number	:	773-777-4444
Fax Number	:	312-736-7873

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	08/16/2018

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Directions to “ DR. CHERYL B KRAFF COOPER M.D.” Practice Location

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