Healthcare Provider Details

I. General information

NPI: 1043287956
Provider Name (Legal Business Name): COLEEN NAPOLITANO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 S FIRST AVE (7511 LEMONT RD, DARIEN, IL. 60561)
MAYWOOD IL
60153
US

IV. Provider business mailing address

2160 S FIRST AVE (7511 LEMONT RD, DARIEN, IL. 60561)
MAYWOOD IL
60153
US

V. Phone/Fax

Practice location:
  • Phone: 630-985-4989
  • Fax: 630-985-4540
Mailing address:
  • Phone: 630-985-4989
  • Fax: 630-985-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number16004405
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number16004405
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: