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Individual
CRYSTAL WESOCKES COOPER
Active
Individual
CRYSTAL WESOCKES COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
085004955
IL
363A00000X
Physician Assistant
085004955
IL
363AS0400X
Surgical Physician Assistant
Primary
085004955
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633878
BCBS IL
IL
Enumeration date
11/26/2013
Last updated
03/31/2025
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