Individual
DR. KENNETH A COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
645 N MICHIGAN AVE, SUITE 822, CHICAGO, IL 60611
(312) 337-4404
Mailing address
645 N MICHIGAN AVE STE 822, CHICAGO, IL 60611-2879
(312) 337-4404
(877) 308-5358
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
36-072165
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31602745
BLUECROSSBLUESHIELD PROVI
IL
Enumeration date
04/18/2006
Last updated
05/17/2018
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