Provider Demographics
NPI:1598985517
Name:COOK, RENEE (DO)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19642
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:55746
Mailing Address - Country:US
Mailing Address - Phone:218-263-9237
Mailing Address - Fax:218-262-3150
Practice Address - Street 1:3203 W. 3RD AVE.
Practice Address - Street 2:RANGE MENTAL HEALTH CENTER-PERPICH BUILDING
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746
Practice Address - Country:US
Practice Address - Phone:218-263-9237
Practice Address - Fax:218-262-3150
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-0476942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry