Healthcare Provider Details

I. General information

NPI: 1285051615
Provider Name (Legal Business Name): CHRISTOPHER COLBY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W. CENTRAL RD.
ARLINGTON HEIGHTS IL
60005
US

IV. Provider business mailing address

1600 W. CENTRAL RD.
ARLINGTON HEIGHTS IL
60005
US

V. Phone/Fax

Practice location:
  • Phone: 847-392-6220
  • Fax: 847-392-6236
Mailing address:
  • Phone: 847-392-6220
  • Fax: 847-392-6236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number021-002885
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: