Provider Demographics
NPI:1134518087
Name:COHEN, LIZA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:MICHELLE
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST STE 1520
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3111
Mailing Address - Country:US
Mailing Address - Phone:312-695-8150
Mailing Address - Fax:312-695-3652
Practice Address - Street 1:259 E ERIE ST STE 1520
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3111
Practice Address - Country:US
Practice Address - Phone:312-695-8150
Practice Address - Fax:312-695-3652
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA160544207WX0200X
IL036156884207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery