Individual
LISA BROOKE COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
5012 W LAWRENCE AVE, CHICAGO, IL 60630-3822
(773) 282-3377
(773) 205-4439
Mailing address
5012 W LAWRENCE AVE, CHICAGO, IL 60630-3822
(773) 282-3377
(773) 205-4439
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005305
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01600112
BCBS
IL
Enumeration date
06/27/2008
Last updated
01/26/2011
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