Individual
DR. TODD G COHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
4160 IL RTE 83, SUITE 107, LONG GROVE, IL 60047
(847) 955-9393
(847) 955-9857
Mailing address
4160 IL ROUTE 83, SUITE 107, LONG GROVE, IL 60047-8034
(847) 955-9393
(847) 955-9857
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009356
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001604768
BLUE CROSS BLUE SHIELD
IL
05
—
046009356
—
IL
01
—
P00005501
RAILROAD MEDICARE
—
Enumeration date
05/22/2006
Last updated
06/25/2014
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