Provider Demographics
NPI:1497714653
Name:COLLINS, ANN M (DC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-2171
Mailing Address - Country:US
Mailing Address - Phone:847-297-4049
Mailing Address - Fax:847-297-4049
Practice Address - Street 1:1401 E OAKTON ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-2171
Practice Address - Country:US
Practice Address - Phone:847-297-4049
Practice Address - Fax:847-297-4049
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1682483OtherBCBSIL
IL214745Medicare ID - Type UnspecifiedPROVIDER NUMBER
U37192Medicare UPIN