MEDICARE: AARON COHEN 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	2086S0129X	Vascular Surgery Physician	036103820	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01622308	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1679533764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON COHEN MD

Provider Business Mailing Address
First Line	:	1901 BUTTERFIELD RD
Second Line	:	SUITE 220
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-7915
Country	:	US
Telephone Number	:	630-725-2752
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 E LAKE COOK RD
Second Line	:	SUITE 40-C
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1862
Country	:	US
Telephone Number	:	847-465-6025
Fax Number	:

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/24/2008

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