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General NPI Number Information
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NPI Number | 1174913917
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Entity Type | Individual
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Provider Name | PATRICK COFFEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 8505 183RD ST STE A
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City | TINLEY PARK
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State | IL
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Zip | 60487-9354
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Country | US
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Telephone | 815-824-4406
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 GERANIUM CT
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City | NAPERVILLE
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State | IL
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Zip | 60565-5314
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Country | US
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Telephone | 607-768-0542
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 5101025184
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 295327
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 036152279
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License Number State | IL
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