Basic Information
| Provider Information | |||||||||
| NPI: | 1942263090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COTHRAN | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4905 OLD ORCHARD CENTER | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476733130 | ||||||||
| FaxNumber: | 3126953169 | ||||||||
| Practice Location | |||||||||
| Address1: | 4905 OLD ORCHARD CENTER | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476733130 | ||||||||
| FaxNumber: | 3126953169 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 02/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 036-091412 | IL | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 036.091412 | IL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.