Individual
DR. EZRA COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
200 E ROOSEVELT RD, LOMBARD, IL 60148-4539
(630) 889-6846
Mailing address
200 E ROOSEVELT RD, LOMBARD, IL 60148-4539
(630) 889-6846
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038005719
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306760
MEDICARE GROUP
—
Enumeration date
09/19/2008
Last updated
09/19/2008
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