Provider Demographics
NPI:1851358774
Name:COLLINS, ANTHONY F (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:F
Last Name:COLLINS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:302 W HAY ST
Mailing Address - Street 2:SUITE LL110
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4167
Mailing Address - Country:US
Mailing Address - Phone:217-872-7000
Mailing Address - Fax:217-233-1564
Practice Address - Street 1:302 W HAY ST
Practice Address - Street 2:SUITE LL110
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4167
Practice Address - Country:US
Practice Address - Phone:217-872-7000
Practice Address - Fax:217-233-1564
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360978922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097892Medicaid
ILK27275Medicare PIN
ILG27497Medicare UPIN