Provider Demographics
NPI:1508815028
Name:COBBINS, LORRI (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRI
Middle Name:
Last Name:COBBINS
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 1:601 W RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2232
Mailing Address - Country:US
Mailing Address - Phone:312-258-9100
Mailing Address - Fax:312-258-1219
Practice Address - Street 1:601 W RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-2232
Practice Address - Country:US
Practice Address - Phone:312-258-9100
Practice Address - Fax:312-258-1219
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036129559208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL2321002OtherMEDICARE PTAN