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General NPI Number Information
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NPI Number | 1760061469
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Entity Type | Individual
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Provider Name | HIREN KOLLI MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 3122 N. ASHLAND AVE.
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City | CHICAGO
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State | IL
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Zip | 60657-3014
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Country | US
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Telephone | 847-663-8060
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Fax | 773-687-7795
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-982-3172
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036175706
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License Number State | IL
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