MEDICARE: ADAM COHEN DDS

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	1223G0001X	General Practice Dentistry	019.033105	IL

General Provider Information

NPI Number	:	1649847385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM COHEN DDS

Provider Business Mailing Address
First Line	:	195 N ARLINGTON HEIGHTS RD STE 160
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1768
Country	:	US
Telephone Number	:	847-215-1511
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 N ARLINGTON HEIGHTS RD STE 160
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1768
Country	:	US
Telephone Number	:	847-215-1511
Fax Number	:

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

Provider Enumeration Date	:	06/10/2021
Last Update Date	:	06/10/2021

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