Provider Demographics
NPI:1265465728
Name:KOKO, ISOKEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ISOKEN
Middle Name:
Last Name:KOKO
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 1:8961 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-8394
Mailing Address - Country:US
Mailing Address - Phone:630-794-9475
Mailing Address - Fax:708-488-9660
Practice Address - Street 1:7420 W CENTRAL
Practice Address - Street 2:CENTER FOR CANCER CARE
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1800
Practice Address - Country:US
Practice Address - Phone:708-763-2700
Practice Address - Fax:708-488-9660
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100278207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH14079Medicare UPIN