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Individual

DR. BLAKE ELLIOT COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-142632
IL
2085R0202X
Diagnostic Radiology Physician
2011018942
MO
2085R0202X
Diagnostic Radiology Physician
60184
MN

Other

Enumeration date
04/05/2011
Last updated
01/23/2024
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