Cooper, Wayne Elliot

Cooper, Wayne Elliot is an individual health care provider with primary practice located at 40 Skokie Blvd Ste 520 , Northbrook IL 60062-1601. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Cooper, Wayne Elliot can be contacted via phone (847) 504-5000.

Contact Information

Primary practice address
40 Skokie Blvd Ste 520 Northbrook IL 60062-1601
Phone: (847) 504-5000
Fax: (847) 504-5015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016003174 Illinois

Profile Details

NPI number 1750338935
LBN Legal business name Cooper, Wayne Elliot
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jan 22nd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750338935 NPPES
Illinois MEDICAID 016003174
Illinois Other 07000891
Illinois Other 016003174
Illinois Other P01693978
Illinois MEDICAID 200258730

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