Healthcare Provider Details

I. General information

NPI: 1942401948
Provider Name (Legal Business Name): SARAH ABBIE COLLINS M.D., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E SUPERIOR ST 02-2304
CHICAGO IL
60611-2914
US

IV. Provider business mailing address

250 E SUPERIOR ST 03-2304
CHICAGO IL
60611-2914
US

V. Phone/Fax

Practice location:
  • Phone: 646-265-4170
  • Fax:
Mailing address:
  • Phone: 646-265-4270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number01070578A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number036128467
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number01070578A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number036.128467
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-128467
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: