Jack Cooksey, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036038562 Issued in IL

Practice address

2505 Lawndale Ave
Evanston, IL 60201-1157

Phone

(847) 475-8184

NPI assigned

Oct 14, 2011

Last updated

Oct 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1497030068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 LAWNDALE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011157",
            "telephone_number": "847-475-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 LAWNDALE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011157",
            "telephone_number": "847-475-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036038562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Carol Coogan
• Cook Physician Services, P.C.
• Alexander Cook, MD
• David John Cook, MD
• John Ian Zachery Cooke
• Katharine Coombes, DPT
• Eric Cooper
• Jennifer Coopmans, LCPC
• Sarah Copeland, PA-C
• Julie Gail Coplon, PHD

• Specialist in Evanston, IL
• Providers in Evanston, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.