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General NPI Number Information
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NPI Number | 1205471083
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Entity Type | Individual
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Provider Name | SYLVIA COLEMAN AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 20 W KINZIE ST STE 17
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City | CHICAGO
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State | IL
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Zip | 60654-6393
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Country | US
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Telephone | 312-776-2446
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Fax | 312-776-2459
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Provider Business Mailing Address
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Address Line | 2422 183RD ST APT 208
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City | HOMEWOOD
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State | IL
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Zip | 60430-3129
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Country | US
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Telephone |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209020394
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License Number State | IL
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