Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | IL |
NPI | 1487799581 |
---|---|
Provider Name | Dr. Thomas N Collins |
First Address | Wilmette, IL 60091-1559 |
Second Address | Wilmette, IL 60091-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |