Individual
JONATHAN EDWARD COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N2450
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036127781
IL
207RP1001X
Pulmonary Disease Physician
036127781
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036127781
MEDICAID
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400201360
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
11/18/2008
Last updated
05/11/2017
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