Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 036135522 | IL |
N | 2086X0206X | Surgical Oncologist | 036135522 | IL |
NPI | 1205002607 |
---|---|
Provider Name | Matthew Wesley Colman |
First Address | Westchester, IL 60154-5701 |
Second Address | Chicago, IL 60612-4861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 09/10/2018 |