Provider Demographics
NPI:1043287956
Name:NAPOLITANO, COLEEN (DPM)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:
Last Name:NAPOLITANO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 S FIRST AVE
Mailing Address - Street 2:(7511 LEMONT RD, DARIEN, IL. 60561)
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153
Mailing Address - Country:US
Mailing Address - Phone:630-985-4989
Mailing Address - Fax:630-985-4540
Practice Address - Street 1:2160 S FIRST AVE
Practice Address - Street 2:(7511 LEMONT RD, DARIEN, IL. 60561)
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:630-985-4989
Practice Address - Fax:630-985-4540
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16004405207X00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL16004405Medicaid
ILL98025Medicare ID - Type Unspecified
T93115Medicare UPIN
IL16004405Medicaid