; NPI #1710612478

Contact Information

MARVIN COKLOW

5030 N MARINE DR
CHICAGO, IL 60640-3267

Phone: 773-597-7698
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Point of Service	305S00000X

Indicates primary specialty

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NPI Profile & details for

NPI Number	`1710612478`
Entity	Organization
Organization subpart ¹	Not specified
Enumeration date	07/18/2022
Last updated	07/18/2022 - About 4 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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