Provider Demographics
NPI:1376601336
Name:COLE, GEORGE WINTHER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WINTHER
Last Name:COLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 S CREGIER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1019
Mailing Address - Country:US
Mailing Address - Phone:773-752-2084
Mailing Address - Fax:
Practice Address - Street 1:6727 S CREGIER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-1019
Practice Address - Country:US
Practice Address - Phone:773-752-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9361208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery