Individual
DR. RICHARD W. COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
806 RIDGE TER, EVANSTON, IL 60201-2430
(847) 328-5022
(847) 328-5022
Mailing address
806 RIDGE TER, EVANSTON, IL 60201-2430
(847) 328-5022
(847) 328-5022
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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