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Individual

DR. RICHARD W. COHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-000621
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04972024
BLUE CROSS
IL
01
905520
MEDICARE ID
IL
01
L010828
CHAMPUS
IL
Enumeration date
10/18/2005
Last updated
10/02/2018
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