Individual
DR. JACK COOKSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2505 LAWNDALE AVE, EVANSTON, IL 60201-1157
(847) 475-8184
Mailing address
2505 LAWNDALE AVE, EVANSTON, IL 60201-1157
(847) 475-8184
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036038562
IL
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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