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Individual

DR. JEREMY COWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
8751 S GREENWOOD AVE, #108, CHICAGO, IL 60619-7051
(773) 978-3338
(773) 978-4606
Mailing address
8751 S GREENWOOD AVE, #108, CHICAGO, IL 60619-7051
(773) 978-3338
(773) 978-4606

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004924
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1633823
BCBS
IL
01
601015700
DEPT OF LABOR
IL
01
P00072953
RAILROAD MEDICARE NUMBER
Enumeration date
06/12/2006
Last updated
11/03/2011
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