Provider Demographics
NPI:1558396382
Name:COHEN, LISA KAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:KAY
Last Name:COHEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1231 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1551
Mailing Address - Country:US
Mailing Address - Phone:847-251-1158
Mailing Address - Fax:847-251-2065
Practice Address - Street 1:1231 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1551
Practice Address - Country:US
Practice Address - Phone:847-251-1158
Practice Address - Fax:847-251-2065
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics