Individual
MS. CORY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT ,DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070015720
IL
225100000X
Physical Therapist
Primary
5501016753
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROVIDER ID
IL
01
—
203
BLUE CROSS PROVIDER ID
IL
01
—
4117
HAMP PROVIDER #
IL
01
—
7216
PERSONALCARE PROVIDER ID
IL
Enumeration date
08/23/2007
Last updated
04/25/2019
Update your record
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