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General NPI Number Information
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NPI Number | 1841371184
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Entity Type | Organization
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Legal Business Name | COLLETTE ARA HONORE MDSC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1525 E 55TH ST
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City | CHICAGO
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State | IL
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Zip | 60615-5512
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Country | US
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Telephone | 773-667-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 4938 S WASHINGTON PARK CT
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City | CHICAGO
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State | IL
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Zip | 60615-2304
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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 | DERMATOLOGIST
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Name | DR. COLLETTE ARA HONORE
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Credential | MD
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Telephone | 312-404-1602
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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 |
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License Number State | IL
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