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NPI Code Detail

MEDICARE: THOMAS MICHAEL COHEN O.D.

MEDICARE:   THOMAS MICHAEL COHEN  O.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
1152W00000XOptometrist046011335IL

General Provider Information

NPI Number : 1992359327
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS MICHAEL COHEN O.D.
Provider Business Mailing Address
First Line : 1909 W ROSCOE ST UNIT 3
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1029
Country : US
Telephone Number : 847-287-8061
Fax Number :
Provider Business Practice Location Address
First Line : 3250 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1117
Country : US
Telephone Number : 773-935-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2019
Last Update Date : 07/24/2019

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Directions to “ THOMAS MICHAEL COHEN O.D.” Practice Location

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