MEDICARE: CHRISTIAN COLON MSW, LSW

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
1	104100000X	Social Worker	150.113017	IL

General Provider Information

NPI Number	:	1407604705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN COLON MSW, LSW

Provider Business Mailing Address
First Line	:	1616 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3981
Country	:	US
Telephone Number	:	708-831-2242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3981
Country	:	US
Telephone Number	:	708-831-2242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2024
Last Update Date	:	05/10/2024

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