Colegrove, Tanner L

Colegrove, Tanner L is an individual health care provider with primary practice located at 900 N Westmoreland Rd Suite # 207, Lake Forest IL 60045-1674. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Colegrove, Tanner L can be contacted via phone (847) 234-9110.

Contact Information

Primary practice address
900 N Westmoreland Rd Suite # 207 Lake Forest IL 60045-1674
Phone: (847) 234-9110
Fax: (847) 234-0900
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X Illinois

Profile Details

NPI number 1003941113
LBN Legal business name Colegrove, Tanner L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003941113 NPPES
Illinois Other 4915052 IL BLUE CROSS BLUE SHIELD

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