Provider Demographics
NPI:1790219814
Name:KOLLMANN, KAITLYN M (MD)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:M
Last Name:KOLLMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 N YORK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3515
Mailing Address - Country:US
Mailing Address - Phone:312-319-1978
Mailing Address - Fax:312-262-7791
Practice Address - Street 1:737 N MICHIGAN AVE STE 720
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6661
Practice Address - Country:US
Practice Address - Phone:312-319-1978
Practice Address - Fax:312-262-7791
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.157717207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology