Provider Demographics
NPI:1861456410
Name:COPE, TAYLOR II (MD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:COPE
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 WALLACE DR
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1132
Mailing Address - Country:US
Mailing Address - Phone:708-799-7557
Mailing Address - Fax:
Practice Address - Street 1:3611 W 183RD ST
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2409
Practice Address - Country:US
Practice Address - Phone:708-799-5900
Practice Address - Fax:708-799-6038
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036051211207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036051211Medicaid
C41107Medicare UPIN
ILK37974Medicare PIN