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Individual

DR. J WESLEY COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5801 W CORCORAN PL, CHICAGO, IL 60644
(773) 285-6400
(773) 498-3096
Mailing address
4101 N RAVENSWOOD AVE, CHICAGO, IL 60613-2193
(773) 285-6400
(773) 498-3096

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36080259
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036080259
IL
01
0586501
AETNA PROVIDER NUMBER
IL
01
31604484
BLUE CROSS BLUE SHIELD
IL
01
725326
HUMANA PROVIDER NUMBER
IL
Enumeration date
10/06/2005
Last updated
03/22/2023
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