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General NPI Number Information
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NPI Number | 1528604154
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Entity Type | Individual
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Provider Name | CAROL L COLLINS PT
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Gender | Female
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 7370 W TALCOTT AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3751
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Country | US
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Telephone | 872-226-2443
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Fax |
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Provider Business Mailing Address
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Address Line | 5435 N MAGNET AVE
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City | CHICAGO
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State | IL
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Zip | 60630-1217
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Country | US
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Telephone | 872-226-2443
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.008597
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License Number State | IL
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