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NPI Code Detail

MEDICARE: DR. ALICIA MARIE COHLER DC

MEDICARE: DR. ALICIA MARIE COHLER DC
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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16152151OTHERILCIGNA PROVIDER ID NUMBER
27085576OTHERILAENTA PIN NUMBER
301632909OTHERILBLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number : 1558440347
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALICIA MARIE COHLER DC
Provider Business Mailing Address
First Line : 1630 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3808
Country : US
Telephone Number : 773-276-2801
Fax Number : 773-276-2803
Provider Business Practice Location Address
First Line : 1630 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3808
Country : US
Telephone Number : 773-276-2801
Fax Number : 773-276-2803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 07/08/2007

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