Organization
DR. J. WESLEY COOK, D.O., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J WESLEY COOK D.O. (OWNER)
(773) 404-1000
Entity
Organization
Contact information
Practice address
2001 W ADDISON ST, CHICAGO, IL 60618-6132
(773) 404-1000
(773) 404-9750
Mailing address
2001 W ADDISON ST, CHICAGO, IL 60618-6132
(773) 404-1000
(773) 404-9750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36080259
IL
207QA0401X
Addiction Medicine (Family Medicine) Physician
336043254
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0586501
AETNA
IL
01
—
31604484
BCBS OF IL
IL
01
—
725326
HUMANA
IL
Enumeration date
04/15/2010
Last updated
04/15/2010
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