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Individual

DAVID A COOKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25 WINFIELD ROAD, WINFIELD, IL 60190
(630) 933-4700
(630) 933-4721
Mailing address
25 WINFIELD ROAD, WINFIELD, IL 60190
(630) 933-4700
(630) 933-4721

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036055493
IL
208M00000X
Hospitalist Physician
036055493
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0222075
BLUE CROSS GROUP NUMBER
IL
05
036055493
IL
01
363149833
TAX IDENTIFICATION NUMBER
IL
01
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
07/10/2006
Last updated
05/24/2009
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