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NPI Code Detail

MEDICARE: DR. MARY B COLLINS MD

MEDICARE: DR. MARY B COLLINS MD
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
1208000000XPediatrics Physician036064956IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760463111
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY B COLLINS MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 5057 SHORELINE RD
Second Line :
City : LAKE BARRINGTON
State : IL
Zip : 60010-1700
Country : US
Telephone Number : 847-381-5005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 09/19/2022

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Directions to “ DR. MARY B COLLINS MD” Practice Location

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