Provider Demographics
NPI:1629230834
Name:LIBERMAN, COLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:
Last Name:LIBERMAN
Suffix:
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 1:2523 N MAPLEWOOD AVE
Mailing Address - Street 2:APT #1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1928
Mailing Address - Country:US
Mailing Address - Phone:773-360-8179
Mailing Address - Fax:
Practice Address - Street 1:2523 N MAPLEWOOD AVE
Practice Address - Street 2:APT #1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1928
Practice Address - Country:US
Practice Address - Phone:773-360-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.119008207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology