Provider Demographics
NPI:1710541255
Name:STEVEN M COHEN MD FACS MINIMALLY INVASIVE SURGERY INCORPORATED
Entity Type:Organization
Organization Name:STEVEN M COHEN MD FACS MINIMALLY INVASIVE SURGERY INCORPORATED
Other - Org Name:STEVEN M COHEN MD FACS MINIMALLY INVASIVE SURGERY INCORPORATED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-927-1268
Mailing Address - Street 1:3 GOLF CTR # 363
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4910
Mailing Address - Country:US
Mailing Address - Phone:847-232-9477
Mailing Address - Fax:847-232-9641
Practice Address - Street 1:1585 BARRINGTON RD STE 506
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5020
Practice Address - Country:US
Practice Address - Phone:847-927-1268
Practice Address - Fax:847-232-9641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036023619Medicaid