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NPI Code Detail

MEDICARE: THOMAS PETER COLLINS II OD

MEDICARE: THOMAS PETER COLLINS II OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2152W00000XOptometristOPT003416GA
3152W00000XOptometrist046011541IL

General Provider Information

NPI Number : 1083289573
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS PETER COLLINS II OD
Provider Business Mailing Address
First Line : 858 CHARLES ALLEN DR NE APT 2
Second Line :
City : ATLANTA
State : GA
Zip : 30308-4526
Country : US
Telephone Number : 330-936-8823
Fax Number :
Provider Business Practice Location Address
First Line : 3241 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-4201
Country : US
Telephone Number : 312-225-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2021
Last Update Date : 02/02/2026

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Directions to “ THOMAS PETER COLLINS II OD” Practice Location

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