Healthcare Provider Details

I. General information

NPI: 1225532492
Provider Name (Legal Business Name): MATTHEW NOLAN COLLINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 OGDEN AVE STE 160
AURORA IL
60504-4383
US

IV. Provider business mailing address

2000 OGDEN AVE STE P050
AURORA IL
60504-5893
US

V. Phone/Fax

Practice location:
  • Phone: 630-851-6440
  • Fax: 630-851-7001
Mailing address:
  • Phone: 630-499-2404
  • Fax: 630-499-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036154990
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number036154990
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: