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NPI Code Detail

MEDICARE: COLIN OVERTON

MEDICARE: COLIN OVERTON
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1639621147
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLIN OVERTON
Provider Business Mailing Address
First Line : 1111 N WELLS ST STE 400
Second Line :
City : CHICAGO
State : IL
Zip : 60610-7632
Country : US
Telephone Number : 312-573-8860
Fax Number :
Provider Business Practice Location Address
First Line : 1111 N WELLS ST STE 400
Second Line :
City : CHICAGO
State : IL
Zip : 60610-7632
Country : US
Telephone Number : 312-573-8860
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2016
Last Update Date : 11/01/2016

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Directions to “ COLIN OVERTON ” Practice Location

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