Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 036061289 | IL |
NPI | 1114940236 |
---|---|
Provider Name | Dr. Karen L Collins |
First Address | Palatine, IL 60067-2414 |
Second Address | Palatine, IL 60067-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036061289 | STATE LICENSE (01) | IL |
C43988 | (02) |