Cox, Jack Gerard

Cox, Jack Gerard is an sole proprietor health care provider with primary practice located at 456 W Frontage Rd Suite 28, Northfield IL 60093-3034. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cox, Jack Gerard can be contacted via phone (847) 220-2224.

Contact Information

Primary practice address
456 W Frontage Rd Suite 28 Northfield IL 60093-3034
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois

Profile Details

NPI number 1033269535
LBN Legal business name Cox, Jack Gerard
Credentials MSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2007
Last updated Jul 8th, 2007 - about 17 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 1033269535 NPPES
Illinois Other 01636627 BLUECROSSBLUESHIELD

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