Provider Demographics
NPI:1871070243
Name:COCO HEALTH MANAGEMENT, LLC
Entity type:Organization
Organization Name:COCO HEALTH MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:224-307-6915
Mailing Address - Street 1:800 ELGIN RD APT 1515
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-5630
Mailing Address - Country:US
Mailing Address - Phone:224-307-6915
Mailing Address - Fax:
Practice Address - Street 1:800 ELGIN RD APT 1515
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5630
Practice Address - Country:US
Practice Address - Phone:224-307-6915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0199841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1134590649OtherTYPE I NPI
IL149.019984OtherLCSW
IL14199014OtherCAHQ