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NPI Code Detail

MEDICARE: DR. EDWARD H. KOLB M.D.

MEDICARE: DR. EDWARD H. KOLB M.D.
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
1207X00000XOrthopaedic Surgery Physician036-108279IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538168786
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD H. KOLB M.D.
Provider Business Mailing Address
First Line : 1120 N MELVIN ST
Second Line :
City : GIBSON CITY
State : IL
Zip : 60936-1477
Country : US
Telephone Number : 217-784-4251
Fax Number :
Provider Business Practice Location Address
First Line : 501A S TOWANDA BARNES RD STE 2
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61705-4031
Country : US
Telephone Number : 309-612-9002
Fax Number : 309-391-0134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 10/02/2025

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