MEDICARE: COLLIN THOMAS CARTWRIGHT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	125.086027	IL
2	390200000X	Student in an Organized Health Care Education/Training Program	125	IL

General Provider Information

NPI Number	:	1477347862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLIN THOMAS CARTWRIGHT DO

Provider Business Mailing Address
First Line	:	7435 W TALCOTT AVE STE 182
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3707
Country	:	US
Telephone Number	:	773-792-5155
Fax Number	:	773-990-8945

Provider Business Practice Location Address
First Line	:	7435 W TALCOTT AVE STE 182
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3707
Country	:	US
Telephone Number	:	773-792-5155
Fax Number	:	773-990-8945

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	12/12/2025

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