Provider Demographics
NPI:1013923630
Name:COTLER, SHELDON (PHD)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:COTLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 BRAESIDE LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5522
Mailing Address - Country:US
Mailing Address - Phone:847-498-5777
Mailing Address - Fax:847-498-5598
Practice Address - Street 1:1535 LAKE COOK RD
Practice Address - Street 2:111
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1447
Practice Address - Country:US
Practice Address - Phone:847-498-4744
Practice Address - Fax:847-498-4811
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical