MEDICARE: COLLETTE ARA HONORE MDSC

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	207N00000X	Dermatology Physician		IL

General Provider Information

NPI Number	:	1841371184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLETTE ARA HONORE MDSC

Provider Business Mailing Address
First Line	:	4938 S WASHINGTON PARK CT
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 E 55TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-5512
Country	:	US
Telephone Number	:	773-667-5577
Fax Number	:

Authorized Official
Title or Position	:	DERMATOLOGIST
Name	:	DR. COLLETTE ARA HONORE
Credential	:	MD
Telephone Number	:	312-404-1602

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	08/22/2020

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