Provider Demographics
NPI:1346534724
Name:COLEN, ADAM EMIL (DO)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:EMIL
Last Name:COLEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6000 N ALLEN ROAD
Mailing Address - Street 2:MIDWEST ORTHOPAEDIC CENTER SC
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614
Mailing Address - Country:US
Mailing Address - Phone:309-691-1400
Mailing Address - Fax:309-689-7094
Practice Address - Street 1:6000 N ALLEN ROAD
Practice Address - Street 2:MIDWEST ORTHOPAEDIC CENTER SC
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614
Practice Address - Country:US
Practice Address - Phone:309-691-1400
Practice Address - Fax:309-689-7094
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2019-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036138270207Q00000X
KYTP812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine