Individual
JOSEPH JAY COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-0123
Mailing address
4065 GRESHAM ST, SAN DIEGO, CA 92109-5813
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
036.124321
IL
2084P0800X
Psychiatry Physician
Primary
036.124321
IL
Other
Enumeration date
02/02/2007
Last updated
03/08/2018
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