Individual
MARVIN COKLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5030 N MARINE DR, CHICAGO, IL 60640-3267
(773) 597-7698
Mailing address
5030 N MARINE DR, CHICAGO, IL 60640-3267
(773) 597-7698
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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