Provider Demographics
NPI:1063721264
Name:KOHEN, NADYA M (PA)
Entity type:Individual
Prefix:MRS
First Name:NADYA
Middle Name:M
Last Name:KOHEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:NADYA
Other - Middle Name:MONIQUE
Other - Last Name:MODLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2400 N. ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614
Mailing Address - Country:US
Mailing Address - Phone:773-270-5600
Mailing Address - Fax:773-360-7378
Practice Address - Street 1:2400 N. ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-270-5600
Practice Address - Fax:773-360-7378
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2672363A00000X
IL085.003935363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant