Provider Demographics
NPI:1891814240
Name:KOHN, IRVING (MD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:
Last Name:KOHN
Suffix:
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 1:6437 N FRANCISCO
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5202
Mailing Address - Country:US
Mailing Address - Phone:773-465-2295
Mailing Address - Fax:
Practice Address - Street 1:6437 N FRANCISCO
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645
Practice Address - Country:US
Practice Address - Phone:773-743-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C41508Medicare UPIN
IL675580Medicare ID - Type Unspecified