Individual provider Active NPI

Bonnie M Cohen, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Racine, WI
National Provider Identifier
1437422359
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
041162115 Issued in IL
Practice address
5735 Durand Ave
Suite
Racine, WI 53406-5011
Phone
(877) 804-3337
NPI assigned
Feb 23, 2012
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 154035-030 WI
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 041162115 IL Primary

Addresses

Primary practice location

5735 Durand Ave
Suite
Racine, WI 53406-5011

Mailing address

5735 Durand Ave Ste a
Mount Pleasant, WI 53406-5011
Phone (877) 804-3337

Other practice location 1

24647 N Milwaukee Ave
Vernon Hills, IL 60061-1567
Phone (847) 377-7950 ext. 7842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041162115ILMDAddiction (Substance Use Disorder) Registered Nurse
154035-030WIMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1437422359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 DURAND AVE STE A",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065011",
            "telephone_number": "877-804-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 DURAND AVE",
            "address_2": "SUITE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065011",
            "telephone_number": "877-804-3337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24647 N Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Vernon Hills",
            "state": "IL",
            "postal_code": "600611567",
            "country_code": "US",
            "telephone_number": "847-377-7950 x7842",
            "fax_number": "847-984-5635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "BONNIE",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "154035-030",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "041162115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.