Provider Demographics
NPI:1720005630
Name:NEUROSCIENCES, LTD
Entity Type:Organization
Organization Name:NEUROSCIENCES, LTD
Other - Org Name:NORMAN V. KOHN, MD, SC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-443-0099
Mailing Address - Street 1:5501 W 79TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-1784
Mailing Address - Country:US
Mailing Address - Phone:773-884-4523
Mailing Address - Fax:773-884-4580
Practice Address - Street 1:122 S MICHIGAN AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6191
Practice Address - Country:US
Practice Address - Phone:312-443-0099
Practice Address - Fax:312-896-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360555272084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01621927OtherBLUE SHIELD
IL036055527Medicaid
130019181OtherRAILROAD MEDICARE
IL036055527Medicaid