Colloton, Edward Leslie

Colloton, Edward Leslie is an individual health care provider with primary practice located at 1505 Eastland Dr Ste 2200, Bloomington IL 61701-7910. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Colloton, Edward Leslie can be contacted via phone (309) 662-7700.

Contact Information

Primary practice address
1505 Eastland Dr Ste 2200 Bloomington IL 61701-7910
Phone: (309) 662-7700
Fax: (309) 662-0829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X Illinois

Profile Details

NPI number 1023012614
LBN Legal business name Colloton, Edward Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 8th, 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 1023012614 NPPES
Illinois Other 05700231 BC/BS PROVIDER #

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