Colodny, Charles S

Colodny, Charles S is an individual health care provider with primary practice located at 716 S Milwaukee Ave , Libertyville IL 60048-3225. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Colodny, Charles S can be contacted via phone (847) 362-1393.

Contact Information

Primary practice address
716 S Milwaukee Ave Libertyville IL 60048-3225
Phone: (847) 362-1393
Fax: (847) 362-3797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036057093 Illinois

Profile Details

NPI number 1659363893
LBN Legal business name Colodny, Charles S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 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 1659363893 NPPES
Illinois MEDICAID 036057093

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