Provider Demographics
NPI:1447269931
Name:KOHL, JAMES W (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:KOHL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 SHERIDAN RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1625 SHERIDAN RD
Practice Address - Street 2:SUITE G
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1824
Practice Address - Country:US
Practice Address - Phone:847-251-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics