MEDICARE: DR. COLMAN R KRAFF M.D.

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	207W00000X	Ophthalmology Physician		IL

General Provider Information

NPI Number	:	1912953712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLMAN R KRAFF M.D.

Provider Business Mailing Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 606
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-444-1111
Fax Number	:	312-444-1953

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 606
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-444-1111
Fax Number	:	312-444-1953

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/09/2007

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